Active NPI
Kimberly Jay
- Family Nurse Practitioner
- Clarksville, TN
National Provider Identifier
1033501127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19250
- Practice address
- 343 Fallow Cir
Clarksville, TN 37040-2058 - Phone
- (901) 359-5465
- NPI assigned
- Feb 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 99761 | TN | |
| Family Nurse Practitioner | 363LF0000X | 19250 | TN | Primary |
Addresses
Primary practice location
343 Fallow Cir
Clarksville, TN 37040-2058
Mailing address
343 Fallow Cir
Clarksville, TN 37040-2058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99761 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1033501127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "343 FALLOW CIR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370402058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "343 FALLOW CIR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370402058",
"telephone_number": "901-359-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAY",
"first_name": "KIMBERLY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-26",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "99761",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "19250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.