MEDICARE: HIGHLANDS NEUROSURGICAL ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	208100000X	Physical Medicine & Rehabilitation Physician
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	363LA2200X	Adult Health Nurse Practitioner
4	363A00000X	Physician Assistant
5	207T00000X	Neurological Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104830405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLANDS NEUROSURGICAL ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	1 MEDICAL PARK BLVD STE 400E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7431
Country	:	US
Telephone Number	:	423-844-5400
Fax Number	:	423-844-5434

Provider Business Practice Location Address
First Line	:	1 MEDICAL PARK BLVD STE 400E
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-7431
Country	:	US
Telephone Number	:	423-844-5400
Fax Number	:	423-844-5434

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	CAROLYN KISTNER FLETCHER-HELTON
Credential	:
Telephone Number	:	423-844-5412

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	02/09/2026

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