Individual provider Active NPI

Jessica Lynn Hamby, APRN, FNP-BC

  • Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1003474354
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25928 Issued in TN
Practice address
80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone
(865) 482-4078
NPI assigned
Jun 2, 2019
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 25928 TN Primary

Addresses

Primary practice location

80 Vermont Ave
Oak Ridge, TN 37830-6474

Mailing address

158 Catoosa Ridge Rd
Rockwood, TN 37854-3549
Phone (865) 399-2693

Other identifiers 2

IdentifierTypeStateIssuer
Q051436MedicaidTN
212152OtherTNRN LICENSE

Other names 1

  • Mrs. Jessica Lynn Hamby Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hamby.jessica@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191024000365 TN Practitioner - Nurse Practitioner 5496087496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone (865) 482-4078

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
25928TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

80 Vermont Ave
Oak Ridge, TN 37830
Phone (423) 482-4078

Interoperability endpoints

  • Direct secure messaging: hamby.jessica@covenanthealth.cernerdirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1003474354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 CATOOSA RIDGE RD",
            "city": "ROCKWOOD",
            "state": "TN",
            "postal_code": "378543549",
            "telephone_number": "865-399-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306474",
            "telephone_number": "865-482-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-02",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "25928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q051436",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "212152",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hamby.jessica@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "80 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HAMBY",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "JUSTUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.