Individual provider Active NPI

Jennifer Ward, NP

  • Family Nurse Practitioner
  • Tullahoma, TN
National Provider Identifier
1114648490
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31987 Issued in TN
Practice address
108 W Blackwell St
Tullahoma, TN 37388-3505
Phone
(931) 841-3821
Fax
(931) 841-3869
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 31987 TN Primary

Addresses

Primary practice location

108 W Blackwell St
Tullahoma, TN 37388-3505

Mailing address

108 W Blackwell St
Tullahoma, TN 37388-3505
Phone (931) 841-3821

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
I20220915001779 TN Practitioner - Nurse Practitioner 5890170542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Southern Tennessee LLCGroup PAC ID 5991765943, 54 clinicians

Practice addresses (Care Compare)

108 W Blackwell St
Tullahoma, TN 37388-3505
Phone (931) 841-3821

Hospital & facility affiliations

  • Vanderbilt Tullahoma-Harton Hospital Hospital, Tullahoma, TN, CCN 440144
  • Southern Tennessee Regional Health System Winchest Hospital, Winchester, TN, CCN 440058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 31, 2022 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Aug 1, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 31, 2022 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Aug 1, 2023 Accepting new patients
Amg -Southern Tennessee LLC Past Accepting new patients

Locations

1321 Huntsville Hwy
Fayetteville, TN 37334
Phone (931) 297-2201

108 W Blackwell St
Tullahoma, TN 37388
Phone (931) 841-3821

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Interoperability endpoints

  • Direct secure messaging: jennifer.ward.1@19363.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 2

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1114648490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W BLACKWELL ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883505",
            "telephone_number": "931-841-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W BLACKWELL ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883505",
            "telephone_number": "931-841-3821",
            "fax_number": "931-841-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2025-02-04",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.