NPIMap

Individual provider Active NPI

Jennifer S Eisenhower, F.N.P.

  • Family Nurse Practitioner
  • White Pine, TN
National Provider Identifier
1093885337
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000007214 Issued in TN
Practice address
1403 State St
White Pine, TN 37890-3175
Phone
(865) 674-6603
Fax
(865) 674-6695
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 APN0000007214 TN Primary

Addresses

Primary practice location

1403 State St
White Pine, TN 37890-3175

Mailing address

407 4TH St
Newport, TN 37821-3755
Phone (423) 623-6240

Other practice location 1

407 4th St
Newport, TN 37821-3755
Phone (423) 623-6240

Other identifiers 1

IdentifierTypeStateIssuer
3928109MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.eisenhower.1@3525.direct.athenahealth.com Direct

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
I20040205001046 TN Practitioner - Nurse Practitioner 5294628988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthstar Physicians PC 89 clinicians
Champion Physical Therapy LLC Halls 277 clinicians

Practice addresses (Care Compare)

1403 State St
White Pine, TN 37890-3175
Phone (865) 674-6603

3106 Circle Dr
White Pine, TN 37890-3306
Phone (865) 674-7454

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Knoxville, TN, CCN 447312
  • Smoky Mountain Home Health and Hospice, Inc Home health agency, Newport, TN, CCN 447195
  • Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030
  • Tennova Healthcare-Jefferson Memorial Hospital Hospital, Jefferson City, TN, CCN 440056
  • Tennova Healthcare - Newport Medical Center Hospital, Newport, TN, CCN 440153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000007214TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians PC CurrentSince Mar 1, 2011 Accepting new patients
Healthstar Physicians, P.C. CurrentSince Mar 1, 2011 Accepting new patients
East Tennessee Primary Care Associates Past Accepting new patients

Locations

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

420 W Morris Blvd
Ste 400A
Morristown, TN 37813
Phone (423) 318-6617

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

5741 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 585-0686

407 4th St
Newport, TN 37821
Phone (423) 623-6240

1403 State St
White Pine, TN 37890
Phone (423) 674-6603

Interoperability endpoints

  • Direct secure messaging: jennifer.eisenhower.1@3525.direct.athenahealth.com

Organizations & group practices 12

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 5

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1093885337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 4TH ST",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213755",
            "telephone_number": "423-623-6240",
            "fax_number": "423-623-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 STATE ST",
            "city": "WHITE PINE",
            "state": "TN",
            "postal_code": "378903175",
            "telephone_number": "865-674-6603",
            "fax_number": "865-674-6695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 4th St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "TN",
            "postal_code": "378213755",
            "country_code": "US",
            "telephone_number": "423-623-6240",
            "fax_number": "423-623-0102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISENHOWER",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000007214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3928109",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.eisenhower.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1403 State St",
            "city": "White Pine",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378903175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in White Pine, TN

Sources for this page

Verify at the official NPI Registry.