Individual provider Active NPI

Becky Bruce, NP

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1073047189
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22853 Issued in TN
Practice address
221 Sterling Farm Dr
Jackson, TN 38305-5727
Phone
(731) 300-6155
NPI assigned
Apr 14, 2017
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22853 TN Primary
General Practice Registered Nurse 163WG0000X 174736 TN

Addresses

Primary practice location

221 Sterling Farm Dr
Jackson, TN 38305-5727

Mailing address

221 Sterling Farm Dr
Jackson, TN 38305-5727
Phone (731) 300-6155

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
I20250325000298 TN Practitioner - Nurse Practitioner 3476829649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Experts PLLCGroup PAC ID 5597015131, 9 clinicians

Practice addresses (Care Compare)

2255 Parr Ave
Suite B
Dyersburg, TN 38024-2078
Phone (731) 286-1510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174736TNMDGeneral Practice Registered Nurse
22853TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Experts PLLC CurrentSince Sep 23, 2025 Accepting new patients

Locations

1995 Highway 51 S
Ste 208
Covington, TN 38019
Phone (901) 476-7070

1575 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 286-1510

Interoperability endpoints

  • Direct secure messaging: bbruce47527@direct.davitaphysiciansolutions.com

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1073047189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 STERLING FARM DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055727",
            "telephone_number": "731-300-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 STERLING FARM DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055727",
            "telephone_number": "731-300-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "BECKY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22853",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TN",
            "license": "174736",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.