Individual provider Active NPI

Kelly Nicole Jenkins, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1053184432
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
34996 Issued in TN
Practice address
6429 Lee Hwy Ste 103
Chattanooga, TN 37421-4778
Phone
(800) 665-2850
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 34996 TN Primary

Addresses

Primary practice location

6429 Lee Hwy Ste 103
Chattanooga, TN 37421-4778

Mailing address

3623 Parham Dr
Chattanooga, TN 37412-1832
Phone (423) 771-5356

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
I20250402001096 TN Practitioner - Nurse Practitioner 9234652082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TN LLCGroup PAC ID 2365807633, 266 clinicians

Practice addresses (Care Compare)

941 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone (423) 894-7870

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34996TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TN, LLC CurrentSince May 1, 2025 Accepting new patients
Continuum Health Aic Inc Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

2300 Patterson St
#M
Nashville, TN 37203

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1053184432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 PARHAM DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374121832",
            "telephone_number": "423-771-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6429 LEE HWY STE 103",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214778",
            "telephone_number": "800-665-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "34996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.