Individual provider Active NPI

Jade Erica Simon, FNP-BC

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1023470465
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20999 Issued in TN
Practice address
80 Humphreys Center Dr Ste 202
Memphis, TN 38120-2361
Phone
(901) 226-4280
Fax
(901) 226-4282
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 161337 MS
Family Nurse Practitioner 363LF0000X A005652 AR
Family Nurse Practitioner 363LF0000X 161337 TN
Family Nurse Practitioner 363LF0000X 906984 MS
Family Nurse Practitioner 363LF0000X 20999 TN Primary

Addresses

Primary practice location

80 Humphreys Center Dr Ste 202
Memphis, TN 38120-2361

Mailing address

PO Box 405827
Atlanta, GA 30384-5827
Phone (901) 226-3186

Other practice location 1

1251 Wesley Dr
Suite 153
Memphis, TN 38116-6442
Phone (901) 763-0200

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
I20160511000681 TN Practitioner - Nurse Practitioner 8426347618 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A005652ARMDFamily Nurse Practitioner
161337MSMDFamily Nurse Practitioner
906984MSMDFamily Nurse Practitioner
161337TNMDFamily Nurse Practitioner
20999TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Jun 19, 2025 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Jun 19, 2025 Accepting new patients
Baptist Memorial Hospital-Tipton CurrentSince Jun 19, 2025 Accepting new patients
Baptist Memorial Hospital-Tipton CurrentSince Jun 19, 2025 Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

1995 Highway 51 S
Covington, TN 38019
Phone (901) 476-2621

6029 Walnut Grove Rd
Ste 301
Memphis, TN 38120
Phone (901) 747-9081

6029 Walnut Grove Rd
Ste 305
Memphis, TN 38120
Phone (901) 226-0533

80 Humphreys Center Dr
Ste 202
Memphis, TN 38120
Phone (901) 226-4280

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

350 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 226-4003

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1023470465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "901-226-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HUMPHREYS CENTER DR STE 202",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202361",
            "telephone_number": "901-226-4280",
            "fax_number": "901-226-4282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Wesley Dr",
            "address_2": "Suite 153",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381166442",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JADE",
        "middle_name": "ERICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "161337",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005652",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "161337",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906984",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.