Individual provider Active NPI

Jill Cameron, ANP-BC

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1043219744
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8444 Issued in TN
Practice address
205 W Springdale Ave
Knoxville, TN 37917
Phone
(865) 637-9711
Fax
(865) 541-6684
NPI assigned
Jul 15, 2005
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN142089 TN
Nurse Practitioner 363L00000X APN8444 TN
Family Nurse Practitioner 363LF0000X 8444 TN Primary

Addresses

Primary practice location

205 W Springdale Ave
Knoxville, TN 37917

Mailing address

201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

Other identifiers 1

IdentifierTypeStateIssuer
3634235MedicaidTN

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

LicenseStateTypeSpecialty
8444TNMDPhysical Therapist
APN8444TNMDNurse Practitioner
RN142089TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center PastSince Mar 7, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1043219744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711",
            "fax_number": "865-541-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37917",
            "telephone_number": "865-637-9711",
            "fax_number": "865-541-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "JILL",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "RN142089",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN8444",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "8444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3634235",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.