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LORI M MIDDLETON
NPI 1922340371
Nurse Practitioner - Pediatrics in Jacksboro, TN

Active since March 25, 2013PECOS EnrolledAccepts Medicare Assignment
45.6/100
CMS Quality Rating
136 MOUNTAIN PERKINS LN, SUITE 2, JACKSBORO, TN 37757(423) 562-4149(423) 566-6929 Get Directions Write a Review

NPPES record last updated: March 25, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lori M Middleton NPPES

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

LORI M MIDDLETON (NPI 1922340371) is an individual pediatrics provider in Jacksboro, Tennessee, licensed in Tennessee (17495) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1922340371
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameLORI M MIDDLETON
Location Address136 MOUNTAIN PERKINS LN, SUITE 2Jacksboro, TN 37757-2841
Mailing Address125 Town Creek Rd E, Suite 2bLenoir City, TN 37772-5690 · (865) 986-1400 · Fax (865) 986-9400
Phone(423) 562-4149
Fax(423) 566-6929
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 25, 2013
✔ NPI 1922340371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in TN · 17495
136 MOUNTAIN PERKINS LN, Jacksboro, TN 37757
Open in Google Maps ↗

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

Lori M Middleton 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 ID2163797655
PECOS Enrollment IDI20171010000869
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 Lori Middleton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Allergic Diseases Asthma & Immunology Clinic PC
29 mi
Allergy
7417 KINGSTON PIKE STE 101
Knoxville, TN 37919
  • Reassigned Medicare billing, Tennessee enrollment
  • 7 clinicians in this Medicare group
NPI 1205879400 (865) 584-4112

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 8

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.

Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
2,554 services248 patients
Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
470 services17 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.
415 services199 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
111 services39 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
95 services20 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.
39 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37757 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.

45.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.27
Improvement Activities0
Cost59.64

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg J1459
Treatment-Injections and Infusions (nononcologic) · category RI008N
1 supplier15 claims1,440 services$36.31 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Lori Middleton's NPI number?

The NPI number for Lori Middleton is 1922340371. It was assigned to this individual provider in the NPPES registry on March 25, 2013.

Where is Lori Middleton located?

Lori Middleton practices at 136 Mountain Perkins Ln Suite 2, Jacksboro, TN 37757. The listed phone number is (423) 562-4149.

What is Lori Middleton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Lori Middleton enrolled in Medicare?

Yes. Lori Middleton 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 Lori Middleton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lori Middleton reassigns Medicare benefits to Allergic Diseases Asthma & Immunology Clinic PC (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 Lori Middleton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lori Middleton accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 5 other insurers list Lori Middleton 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 Lori Middleton was last updated on March 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.