JOHN BRADFORD LICHLYTER (MSN, APRN, NP-C, CEN) – Emergency Registered Nurse, NPI 1629852900
Emergency Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,664 NURSE PRACTITIONER in TN
Provider Addresses for JOHN BRADFORD LICHLYTER (MSN, APRN, NP-C, CEN)
1021 W OAKLAND AVE STE 310
JOHNSON CITY, TN 376042192
Phone: (423) 302-6565
Type: Mailing
410 N STATE OF FRANKLIN RD STE 130
JOHNSON CITY, TN 376046972
Phone: (423) 431-2477
Type: Location
907 E LaMar Alexander Pkwy
Maryville, TN 378045016
Phone: (865) 804-0322
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240403000390 | I | Nurse Practitioner | TN | TBD |
| I20240513000542 | I | Nurse Practitioner | TX | TBD |
| I20250124002246 | I | Nurse Practitioner | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Nurse Practitioner | WI | |
| Internal Medicine | WI | |
| Nurse Practitioner | WI | |
| Family Practice, Family Practice, Hospitalist, Hospitalist | WI | |
| Physician Assistant | TX | |
| Family Practice | WI | |
| Physician Assistant | CT | |
| - | AZ |
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