Individual provider Active NPI

Jessica B Whaley

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1093116741
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19164 Issued in TN
Practice address
1940 Alcoa Hwy
E210
Knoxville, TN 37920-2244
Phone
(865) 524-7471
Fax
(865) 305-6563
NPI assigned
Sep 12, 2014
Last updated
Sep 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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 19164 TN Primary

Addresses

Primary practice location

1940 Alcoa Hwy
E210
Knoxville, TN 37920-2244

Mailing address

PO Box 440010
Nashville, TN 37244-0010
Phone (865) 670-6199

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
I20150205001228 TN Practitioner - Nurse Practitioner 6406171883 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19164TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System Inc CurrentSince Oct 17, 2014 Accepting new patients
Hospital Medicine Services of Tennessee PC Family CurrentSince Jan 1, 2016 Accepting new patients
University Health System, Inc Current Accepting new patients
University Health System, Inc CurrentSince Oct 17, 2014 Accepting new patients

Locations

1940 Alcoa Hwy
Ste E210
Knoxville, TN 37920
Phone (865) 524-7471

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

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": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1093116741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440010",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440010",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ALCOA HWY",
            "address_2": "E210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202244",
            "telephone_number": "865-524-7471",
            "fax_number": "865-305-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "JESSICA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.