Individual provider Active NPI

Jessica Annette Shehan, APN

  • Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1053903740
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN35356 Issued in TN
Practice address
657 E Broadway Blvd
Jefferson City, TN 37760-4948
Phone
(865) 475-9062
NPI assigned
Feb 4, 2021
Last updated
Dec 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN35356 TN Primary
Registered Nurse 163W00000X 1155465 KY

Addresses

Primary practice location

657 E Broadway Blvd
Jefferson City, TN 37760-4948

Mailing address

657 E Broadway Blvd Ste C
Jefferson City, TN 37760-4949
Phone (865) 475-9062

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
I20240314000150 TN Practitioner - Nurse Practitioner 8426494303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

420 W Morris Blvd
Suite 400H
Morristown, TN 37813-2283
Phone (423) 586-4545

657 E Broadway Blvd
Suite a
Jefferson City, TN 37760-4949
Phone (865) 475-9062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1155465KYMDRegistered Nurse
APN35356TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians, P.C. CurrentSince Dec 1, 2024 Accepting new patients
Healthstar Physicians PC CurrentSince Dec 1, 2024 Accepting new patients
East Tennessee Primary Care Associates Past Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

657 E Broadway Blvd
Ste A
Jefferson City, TN 37760
Phone (865) 475-3101

657 E Broadway Blvd
Jefferson Cty, TN 37760
Phone (865) 262-9777

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

2030 Falling Waters Rd
Ste 325
Knoxville, TN 37922
Phone (865) 951-1300

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

Interoperability endpoints

  • Direct secure messaging: jessica.shehan.1@3525.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, 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": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1053903740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E BROADWAY BLVD STE C",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377604949",
            "telephone_number": "865-475-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 E BROADWAY BLVD",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377604948",
            "telephone_number": "865-475-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHAN",
        "first_name": "JESSICA",
        "middle_name": "ANNETTE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-12-03",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN35356",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1155465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.