Individual provider Active NPI

Vanessa Lee Jaco, CRNP

  • Acute Care Nurse Practitioner
  • Harlan, KY
National Provider Identifier
1114049095
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4010950 Issued in KY
Practice address
37 Ball Park Rd
Harlan, KY 40831-1701
Phone
(606) 573-4520
NPI assigned
Apr 4, 2007
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-087710 AL
Acute Care Nurse Practitioner 363LA2100X 4010950 KY Primary

Addresses

Primary practice location

37 Ball Park Rd
Harlan, KY 40831-1701

Mailing address

37 Ball Park Rd
Harlan, KY 40831-1701
Phone (606) 573-4520

Other identifiers 16

IdentifierTypeStateIssuer
112806MedicaidAL
510-49321OtherALBCBS
510-49443OtherALBCBS
51515966OtherALBCBS
510-49322OtherALBCBS
112809MedicaidAL
510-49323OtherALBCBS
510-49324OtherALBCBS
515-98704OtherALBCBS
P00015330OtherALRAILROAD MEDICARE
051553292MedicaidAL
112804MedicaidAL
112813MedicaidAL
112815MedicaidAL
7100945420MedicaidKY
112805MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vjaco00@arh.medalliesdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071022000646 AL Practitioner - Nurse Practitioner 6608962659
I20231206003859 KY Practitioner - Nurse Practitioner 6608962659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

37 Ball Park Rd
Harlan, KY 40831-1701
Phone (606) 573-4520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-087710ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Healthcare, Inc CurrentSince Dec 1, 2023 Accepting new patients
Appalachian Regional Healthcare, Inc CurrentSince Dec 1, 2023 Accepting new patients
Appalachian Regional Healthcare, Inc Current Accepting new patients
Huntsville Cardiovascular Clinic, P.C. Past Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients

Locations

18880 N US Highway 119
Cumberland, KY 40823
Phone (606) 589-0130

37 Ball Park Rd
Harlan, KY 40831
Phone (606) 263-3900

100 Airport Gardens Rd
Ste 311
Hazard, KY 41701
Phone (606) 439-6978

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1114049095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-4520",
            "fax_number": "606-573-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACO",
        "first_name": "VANESSA",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-087710",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4010950",
            "primary": true
        }
    ],
    "identifiers": [
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        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-49321",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-49443",
            "state": "AL"
        },
        {
            "code": "01",
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            "issuer": "BCBS",
            "identifier": "51515966",
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        },
        {
            "code": "01",
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            "issuer": "BCBS",
            "identifier": "510-49322",
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        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112809",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-49323",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510-49324",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-98704",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00015330",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051553292",
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        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112804",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112813",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112815",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100945420",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112805",
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        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjaco00@arh.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Standard Direct Functionality",
            "address_1": "37 Ball Park Rd",
            "city": "Harlan",
            "state": "KY",
            "country_code": "US",
            "postal_code": "408311701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harlan, KY

Sources for this page

Verify at the official NPI Registry.