Myrvienne Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30362 Issued in TN

Practice address

529 Brandies Cir
Murfreesboro, TN 37128-0710

Phone

(615) 551-4980

NPI assigned

Sep 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Myrvienne Leon Former name

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trustpoint Hospital LLCGroup PAC ID 8325295280, 22 clinicians

Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Trustpoint Hospital LLC

  • Psychiatry Physician
  • Murfreesboro, TN
  • NPI 1518302983

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Ultacare Medical PLLC

  • Family Medicine Physician
  • New Tazewell, TN
  • NPI 1225141492

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Mindful Haven Mental Health Services

  • Psychiatry Physician
  • Murfreesboro, TN
  • NPI 1407681885
  NPD Authorized official
• Trustpoint Hospital LLC

  • Psychiatric Hospital Unit
  • Murfreesboro, TN
  • NPI 1376149955
  NPD
• Xai Family Medical Clinic

  • Family Nurse Practitioner
  • Murfreesboro, TN
  • NPI 1164759601
  NPD (past)

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1013685957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 SYCAMORE LEAF WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371294364",
            "telephone_number": "347-479-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BRANDIES CIR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371280710",
            "telephone_number": "615-551-4980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Brandies Cir Ste A",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371287751",
            "country_code": "US",
            "telephone_number": "615-849-4081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MYRVIENNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30362",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRVIENNE",
            "last_name": "LEON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Amanda Jackson, APRN
• Lacey H Jackson, LCSW
• Madison Jackson, RBT
• Marilyn Moran Jackson, DC
• Morgan F Jackson, MD
• Paul A Jackson, M.D.
• Paul Anthony Jackson Jr.
• Rachelle Moriah Jackson, O.D.
• Shonta Monique Jackson
• Tamba Jackson

• Family Nurse Practitioner in Murfreesboro, TN
• Providers in Murfreesboro, 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 Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.