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OPAL LOUISE CALDWELL FNP
NPI 1548784945
Nurse Practitioner in Morristown, TN

Active since July 28, 2017PECOS EnrolledAccepts Medicare Assignment
89.63/100
CMS Quality Rating
705 N HIGH ST, MORRISTOWN, TN 37814(423) 415-3310(423) 587-9898 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 1, 2020, Jul 28, 2017 (2 updates tracked since 2017).

About Opal Louise Caldwell Fnp NPPES

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

OPAL LOUISE CALDWELL FNP (NPI 1548784945) is an individual nurse practitioner in Morristown, Tennessee, licensed in Tennessee (22887) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS, is affiliated with Morristown Hamblen Hospital Association, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1548784945
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameOPAL LOUISE CALDWELLCredential: FNP
Location Address705 N HIGH STMorristown, TN 37814-3876
Mailing Address705 N High StMorristown, TN 37814-3876 · (423) 415-3310 · Fax (423) 587-9898
Phone(423) 415-3310
Fax(423) 587-9898
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 28, 2017
Last NPPES UpdateSeptember 1, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2020
✔ NPI 1548784945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in TN · 22887
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
705 N HIGH ST, Morristown, TN 37814
Open in Google Maps ↗

Other Names 1

Former Name (1)Opal Louise Swanson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama 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

Opal Louise Caldwell Fnp 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 ID1254605033
PECOS Enrollment IDI20170918000919
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 Reassignment

Medicare enrollment records show Opal Caldwell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Knoxville Hma Physician Management, LLC
35 mi
Pulmonary Disease
4711 CENTERLINE DR STE 100
Knoxville, TN 37917
  • Reassigned Medicare billing, Tennessee enrollment
  • 147 clinicians in this Medicare group
NPI 1629356969 (865) 647-3260

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 6

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 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.
114 services79 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
86 services71 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
73 services73 patients
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.
63 services58 patients
Ultrasound scan of organ tissue for measuring elasticity 76981
An ultrasound scan of organ tissue measures elasticity, or flexibility. This non-invasive procedure uses sound waves to create images of the inside of your body. It helps in assessing the health of various organs by detecting changes in their stiffness or softness.
16 services16 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Morristown Hamblen Hospital Association

Acute Care Hospitals · Morristown, TN
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number440030
Location908 W 4th North StMorristown, TN 37814 · Hamblen County
Emergency services Birthing friendly

Tennova Healthcare-Jefferson Memorial Hospital

Acute Care Hospitals · Jefferson City, TN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number440056
Location110 Hospital DriveJefferson City, TN 37760 · Jefferson County
Emergency services

Claiborne Medical Center

Acute Care Hospitals · Tazewell, TN
OwnershipGovernment - Local
CMS Certification Number440057
Location1850 Old Knoxville HighwayTazewell, TN 37879 · Claiborne County
Emergency services

Tennova Healthcare - Newport Medical Center

Acute Care Hospitals · Newport, TN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number440153
Location435 2nd StNewport, TN 37821 · Cocke County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37814 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.

89.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.66
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 3

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

SHEILA WILLIAMS
Nurse Practitioner (Adult Health)
705 N HIGH ST, SUITE A
MORRISTOWN, TN 37814
Hamblen County (423) 587-0860
SIVA MARAN M.D.
Internal Medicine (Gastroenterology)
705 N HIGH ST, SUITE A
MORRISTOWN, TN 37814
Hamblen County (423) 415-3310
MORRISTOWN GASTROENTEROLOGY, P.C
Internal Medicine (Gastroenterology)
705 N HIGH ST, SUITE A
MORRISTOWN, TN 37814
Hamblen County (423) 587-0860

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 Opal Caldwell's NPI number?

The NPI number for Opal Caldwell is 1548784945. It was assigned to this individual provider in the NPPES registry on July 28, 2017. The provider is also known as Opal Louise Swanson.

Where is Opal Caldwell located?

Opal Caldwell practices at 705 N High St, Morristown, TN 37814. The listed phone number is (423) 415-3310.

What is Opal Caldwell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Opal Caldwell enrolled in Medicare?

Yes. Opal Caldwell 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 organization bills Medicare for Opal Caldwell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Opal Caldwell reassigns Medicare benefits to Knoxville Hma Physician Management, LLC (Knoxville, TN). The 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 Opal Caldwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Opal Caldwell accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 3 other insurers list Opal Caldwell 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 Opal Caldwell affiliated with any hospitals?

According to CMS data, Opal Caldwell is affiliated with Morristown Hamblen Hospital Association, Tennova Healthcare-Jefferson Memorial Hospital, Claiborne Medical Center and Tennova Healthcare - Newport Medical Center.

When was this NPI record last updated?

The NPPES record for Opal Caldwell was last updated on September 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.