NPIMap

Individual provider Active NPI

Jack Dempsey Hydrick II, FNP

  • Family Nurse Practitioner
  • Murfreesboro, TN
National Provider Identifier
1053382648
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7765 Issued in TN
Practice address
2910 South Church St
Ste B
Murfreesboro, TN 37127
Phone
(615) 895-3600
Fax
(615) 895-0024
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7765 TN Primary

Addresses

Primary practice location

2910 South Church St
Ste B
Murfreesboro, TN 37127

Mailing address

2910 South Church St
Ste B
Murfreesboro, TN 37127
Phone (615) 895-3600

Other identifiers 2

IdentifierTypeStateIssuer
4095318OtherTNBCBS
3907988MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000723 TN Practitioner - Nurse Practitioner 3971540238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Barfield Family Walk in ClinicGroup PAC ID 9931331303, 3 clinicians

Practice addresses (Care Compare)

2910 B S Church St
Murfreesboro, TN 37127-7149

2910 S Church St
Suite B
Murfreesboro, TN 37127-7149
Phone (615) 895-3600

2910 S Church St B
Murfreesboro, TN 37127-7149

Hospital & facility affiliations

  • NHC Homecare Murfreesboro Home health agency, Murfreesboro, TN, CCN 447114
  • Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7765TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bell Buckle Family Medical Clinic Family Current Accepting new patients
Urban Elite Rejuvenation and Aesthetics, LLC Family Current Accepting new patients
Barfield Family Walk in Clinic CurrentSince May 27, 2014 Accepting new patients
Central Piedmont Health Services, Inc Past Accepting new patients

Locations

2910 S Church St
Ste B
Murfreesboro, TN 37127
Phone (615) 623-9600

Interoperability endpoints

  • Direct secure messaging: jack.hydrick.1@17005.direct.athenahealth.com

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.

Hospital & facility affiliations 7

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1053382648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 SOUTH CHURCH ST",
            "address_2": "STE B",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37127",
            "telephone_number": "615-895-3600",
            "fax_number": "615-895-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 SOUTH CHURCH ST",
            "address_2": "STE B",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37127",
            "telephone_number": "615-895-3600",
            "fax_number": "615-895-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDRICK",
        "first_name": "JACK",
        "middle_name": "DEMPSEY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "7765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4095318",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3907988",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.