SMOKEY MOUNTAIN MEDICAL LLC
NPI 1902627169
Nurse Practitioner - Family in Jacksboro, TN
About Smokey Mountain Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SMOKEY MOUNTAIN MEDICAL LLC (NPI 1902627169) is a healthcare organization registered as a family in Jacksboro, Tennessee and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through February 16, 2027 and lists Anthony Kingsley, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
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 44D2318703
Smokey Mountain Medical, LLC · Jacksboro, TNOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Smokey Mountain Medical LLC's NPI number?
The NPI number for Smokey Mountain Medical LLC is 1902627169. It was assigned to this organization in the NPPES registry on October 21, 2024.
Where is Smokey Mountain Medical LLC located?
Smokey Mountain Medical LLC is located at 163 Perkins Ln, Jacksboro, TN 37757. The listed phone number is (423) 592-0422.
What is Smokey Mountain Medical LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Smokey Mountain Medical LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D2318703) is associated with this NPI, valid through February 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Smokey Mountain Medical LLC accept?
Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Smokey Mountain Medical LLC 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.
When was this NPI record last updated?
The NPPES record for Smokey Mountain Medical LLC was last updated on November 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Smokey Mountain Medical Llc · NPI 1902627169
Family organization in Jacksboro, Tennessee. Organization record, active in the CMS NPPES registry since October 21, 2024.
## Identity
- **NPI:** 1902627169 (Entity type: Organization)
- **Enumerated:** October 21, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Anthony Kingsley, OWNER
## Practice location
- **Address:** 163 PERKINS LN, Jacksboro, TN 37757-2833
- **Phone:** (423) 592-0422
## Record status
- **NPPES last updated:** November 5, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902627169) · Data from the CMS NPPES public registry.