Individual provider Active NPI

Sally Ruth Hensley, APRN, FNP

  • Family Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1003902578
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12228 Issued in TN
Practice address
153 E Broadway Blvd
Jefferson City, TN 37760-2517
Phone
(865) 471-5110
Fax
(865) 471-5105
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12228 TN Primary

Addresses

Primary practice location

153 E Broadway Blvd
Jefferson City, TN 37760-2517

Mailing address

916 E Highland St
Jefferson City, TN 37760-2726
Phone (865) 617-5081

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
I20070302000448 TN Practitioner - Nurse Practitioner 9638271075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Segue Health Partners LLCGroup PAC ID 5496020521, 29 clinicians

Practice addresses (Care Compare)

765 Woodland Trace LN
Cordova, TN 38018-6609
Phone (901) 626-3515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12228TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Segue Health Partners LLC CurrentSince Aug 15, 2024 Accepting new patients
Afc Urgent Care and Family Care of WNC, PLLC PastSince Dec 1, 2019 Accepting new patients
Mountain Valley RX 05 Inc Past Accepting new patients
East Tennessee Neuropathy, PC PastSince Apr 1, 2013 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shensley@landmarkhealth-direct.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1003902578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 E HIGHLAND ST",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602726",
            "telephone_number": "865-617-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E BROADWAY BLVD",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602517",
            "telephone_number": "865-471-5110",
            "fax_number": "865-471-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "SALLY",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.