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KAREN NICOLE ELDRIDGE ARNP
NPI 1053775973
Nurse Practitioner - Family in Jellico, TN

Active since April 06, 2016PECOS EnrolledAccepts Medicare Assignment
95.69/100
CMS Quality Rating
131 HOSPITAL LN, JELLICO, TN 37762(423) 784-7269(423) 784-3708 Get Directions Write a Review

NPPES record last updated: March 23, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Karen Nicole Eldridge Arnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAREN NICOLE ELDRIDGE ARNP (NPI 1053775973) is an individual family provider in Jellico, Tennessee, licensed in Tennessee (APN21093) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053775973
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKAREN NICOLE ELDRIDGECredential: ARNP
Location Address131 HOSPITAL LNJellico, TN 37762-4404
Mailing AddressPo Box 447Jellico, TN 37762-0447 · (423) 784-7269 · Fax (423) 784-3708
Phone(423) 784-7269
Fax(423) 784-3708
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 6, 2016
Last NPPES UpdateMarch 23, 2017
✔ NPI 1053775973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in TN · APN21093✔ Licensed in KY · 3010209
131 HOSPITAL LN, Jellico, TN 37762
Open in Google Maps ↗

Other Identifiers 4

MedicaidQ025347TN
Medicare PINK148080KY
Medicaid7100431100KY
Medicare PIN1031501477TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Karen Nicole Eldridge Arnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305130303
PECOS Enrollment IDI20160815001756
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Karen Eldridge reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Health System, Inc
15 mi
Internal Medicine
109 INDEPENDENCE LN, STE 200
La Follette, TN 37766
  • Reassigned Medicare billing, Tennessee enrollment
  • 832 clinicians in this Medicare group
NPI 1629099866 (423) 562-4968
Uhs Primary Care LLC
16 mi
Internal Medicine
109 INDEPENDENCE LN STE 200
La Follette, TN 37766
  • Reassigned Medicare billing, Tennessee enrollment
  • 87 clinicians in this Medicare group
NPI 1346048626 (423) 562-4968
Ut Urgent Care Centers LLC
53 mi
Family Medicine
11606 CHAPMAN HWY STE 4
Seymour, TN 37865
  • Reassigned Medicare billing, Tennessee enrollment
  • 72 clinicians in this Medicare group
NPI 1801391453 (865) 579-7580

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
149 services58 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
40 services40 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
38 services26 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Health System, Inc

Acute Care Hospitals · Knoxville, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440015
Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County
Emergency services Birthing friendly

Lafollette Medical Center

Acute Care Hospitals · La Follette, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440033
Location923 East Central AvenueLa Follette, TN 37766 · Campbell County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37762 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.28
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILKENS MEDICAL GROUP INC.
Surgery
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269
DR. RONALD DENNIS HARTMAN M.D.
Family Medicine
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269
KENNETH J REED P.A.C.
Physician Assistant (Medical)
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269
DR. DARRYL JOHN WILKENS M.D.
Family Medicine
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269
HEATHER MAE DEMAREE P.A.C.
Physician Assistant (Medical)
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269
CHARLES H. WILKENS, M.D.,P.C.
Clinic/Center (Rural Health)
131 HOSPITAL LN
JELLICO, TN 37762
Campbell County (423) 784-7269

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Karen Eldridge's NPI number?

The NPI number for Karen Eldridge is 1053775973. It was assigned to this individual provider in the NPPES registry on April 6, 2016.

Where is Karen Eldridge located?

Karen Eldridge practices at 131 Hospital Ln, Jellico, TN 37762. The listed phone number is (423) 784-7269.

What is Karen Eldridge's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Karen Eldridge enrolled in Medicare?

Yes. Karen Eldridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Karen Eldridge's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karen Eldridge reassigns Medicare benefits to 3 organizations: University Health System, Inc (La Follette, TN), Uhs Primary Care LLC (La Follette, TN) and Ut Urgent Care Centers LLC (Seymour, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Karen Eldridge's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Karen Eldridge accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, BlueCross BlueShield of Tennessee and Cigna Healthcare and 2 other insurers list Karen Eldridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Karen Eldridge affiliated with any hospitals?

According to CMS data, Karen Eldridge is affiliated with University Health System, Inc and Lafollette Medical Center.

When was this NPI record last updated?

The NPPES record for Karen Eldridge was last updated on March 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.