Diabetes Center of Jackson, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DIABETES CENTER OF JACKSON, PLLC

Practice address

2782 N Highland Ave Ste C
Jackson, TN 38305-1797

Phone

(731) 602-2778

NPI assigned

Feb 10, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy D Little, ANP-BC, BC-ADM

Title

Owner

Phone

(731) 602-2778

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Tyler Scott, D.C.

  • Chiropractor
  • Jackson, TN
  • NPI 1922004688
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1003315524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CHARLES LATHAM DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383019049",
            "telephone_number": "731-602-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N HIGHLAND AVE STE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051797",
            "telephone_number": "731-602-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES CENTER OF JACKSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-602-2778",
        "authorized_official_credential": "ANP-BC, BC-ADM"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Detox West Tennessee LLC
• Terry M Devall, DMD
• Lindy Deweese, PHARMD
• Stephanie Kim Dewitt, NP-C
• Ahmad N Dhodi, MD
• Dialysis Clinic, Inc.
• Dialysis Docs a Tennessee Partnership
• Zeina Dickerson, MSW
• Dickson Medical Equipment, Inc.
• Kelsey Marie Dickson

• Family Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.