CUMBERLAND GAP MEDICAL
NPI 1336563204
Nurse Practitioner - Family in La Follette, TN

Active since February 12, 2014CLIA 44D2041170 · Waiver
502 W CENTRAL AVE, SUITE 2, LA FOLLETTE, TN 37766(423) 201-9799(423) 437-8162 Get Directions Write a Review

NPPES record last updated: February 12, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cumberland Gap Medical NPPES

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

CUMBERLAND GAP MEDICAL (NPI 1336563204) is a healthcare organization registered as a family in La Follette, Tennessee and active in the NPI registry since February 2014. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists Amanda Sue Collins, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1336563204
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCUMBERLAND GAP MEDICAL
Location Address502 W CENTRAL AVE, SUITE 2La Follette, TN 37766-3400
Mailing Address502 W Central Ave, Suite 2La Follette, TN 37766-3400 · (423) 201-9799 · Fax (423) 437-8162
Fax(423) 437-8162
Organization SubpartNo
Authorized OfficialAmanda Sue CollinsNurse Practitioner · (423) 201-9799
Enumeration DateFebruary 12, 2014
NPI 1336563204 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
License Licensed in TN · APN0000016605
502 W CENTRAL AVE, La Follette, TN 37766

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2041170

Cumberland Gap Medical · Lafollette, TN
Active · expires May 16, 2028
CLIA Number44D2041170
Laboratory TypePractitioner Other
Certificate Effective DateMay 17, 2026
Certificate Expiration DateMay 16, 2028
Laboratory DirectorAmanda G. Brown
Laboratory Phone(423) 201-9799
Laboratory LocationCumberland Gap Medical617 East Central Avenue, Ste 2, Lafollette, TN 37766
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

Family Medicine
502 W CENTRAL AVE
LA FOLLETTE, TN 37766
Social Worker
502 W CENTRAL AVE
LA FOLLETTE, TN 37766
Pharmacy (Community/Retail Pharmacy)
502 W CENTRAL AVE
LA FOLLETTE, TN 37766
Nurse Practitioner (Primary Care)
502 W CENTRAL AVE
LA FOLLETTE, TN 37766
Pharmacist
502 W CENTRAL AVE, RIGGS DRUG
LAFOLLETTE, TN 37766
Pharmacy (Long Term Care Pharmacy)
502 W CENTRAL AVE
LA FOLLETTE, TN 37766

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 Cumberland Gap Medical's NPI number?

The NPI number for Cumberland Gap Medical is 1336563204. It was assigned to this organization in the NPPES registry on February 12, 2014.

Where is Cumberland Gap Medical located?

Cumberland Gap Medical is located at 502 W Central Ave Suite 2, La Follette, TN 37766. The listed phone number is (423) 201-9799.

What is Cumberland Gap Medical's specialty?

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

Does Cumberland Gap Medical hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2041170) is associated with this NPI, valid through May 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cumberland Gap Medical was last updated on February 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.