Individual provider Active NPI

Jessica N Bembry, FNP

  • Family Nurse Practitioner
  • Bristol, VA
National Provider Identifier
1043769490
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21915 Issued in TN
Practice address
743 Island Rd
Bristol, VA 24201-7403
Phone
(276) 469-4200
NPI assigned
Sep 27, 2016
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174175 VA
Family Nurse Practitioner 363LF0000X 21915 TN Primary
Oncology Registered Nurse 163WX0200X 177943 TN

Addresses

Primary practice location

743 Island Rd
Bristol, VA 24201-7403

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

4485 W Stone Dr
Suite 200
Kingsport, TN 37660-1050
Phone (423) 224-3150

Other practice location 2

2202 N John B Dennis Hwy Ste 204
Kingsport, TN 37660-5904
Phone (423) 245-1040

Other practice location 3

671 Highway 58 E
Norton, VA 24273-3007
Phone (276) 679-5874

Other practice location 4

378 Marketplace Blvd Ste 5
Johnson City, TN 37604-2361
Phone (423) 282-0751

Other practice location 5

2202 N John B Dennis Hwy Ste 100
Kingsport, TN 37660-5904
Phone (423) 578-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161123001027 TN Practitioner - Nurse Practitioner 9234418831 Reassigns benefits to 1 organization
I20161208001581 VA Practitioner - Nurse Practitioner 9234418831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WPS Providers IncGroup PAC ID 7719079532, 83 clinicians

Practice addresses (Care Compare)

2202 N John B Dennis Hwy
Suite 110
Kingsport, TN 37660-5904
Phone (423) 578-8400

743 Island Rd
Bristol, VA 24201-7403
Phone (276) 469-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177943TNMDOncology Registered Nurse
0024174175VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc CurrentSince Jan 1, 2017 Accepting new patients
Solstas Lab Partners Group LLC Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

378 Marketplace Blvd
Ste 5
Johnson City, TN 37604
Phone (423) 282-0751

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2202 N John B Dennis Hwy
Ste 100
Kingsport, TN 37660
Phone (423) 245-3161

2202 N John B Dennis Hwy
Ste 110
Kingsport, TN 37660
Phone (423) 578-8400

2202 N John B Dennis Hwy
Ste 204
Kingsport, TN 37660
Phone (423) 224-3300

4485 W Stone Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3150

24530 Falcon Place Blvd
Ste 100
Abingdon, VA 24211
Phone (276) 619-0075

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

743 Island Rd
Bristol, VA 24201
Phone (276) 469-4200

671 Highway 58 E
Norton, VA 24273
Phone (276) 679-5874

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1043769490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 ISLAND RD",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242017403",
            "telephone_number": "276-469-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4485 W Stone Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376601050",
            "country_code": "US",
            "telephone_number": "423-224-3150",
            "fax_number": "423-224-3169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 N John B Dennis Hwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376605904",
            "country_code": "US",
            "telephone_number": "423-245-1040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "671 Highway 58 E",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242733007",
            "country_code": "US",
            "telephone_number": "276-679-5874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "378 Marketplace Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042361",
            "country_code": "US",
            "telephone_number": "423-282-0751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 N John B Dennis Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376605904",
            "country_code": "US",
            "telephone_number": "423-578-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEMBRY",
        "first_name": "JESSICA",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174175",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21915",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "TN",
            "license": "177943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

Verify at the official NPI Registry.