Emily J Jallah, NP

Individual provider Active NPI Family Nurse Practitioner · Henning, TN

NPI 1124544903 · NPPES record last updated Dec 2, 2021

Key facts

NPI
1124544903
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
22958 (TN)
Practice address
480 Green Chapel Rd
Henning, TN 38041-5726
Phone
(901) 844-1434
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Merit-based Incentive Payment System (MIPS)

Final score
21.77 of 100 (individual)
Quality
0
Improvement activities
0
Cost
72.56

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20181024001783 TN Practitioner - Nurse Practitioner 7911250709 Reassigns benefits to 1 organization
Practice locations: Memphis, TN

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22958TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Lakeside LLC Current
since Sep 16, 2018
Accepting new patients

Locations

2911 Brunswick Rd
Bartlett, TN 38133
Phone (901) 373-0905

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22958 TN Yes

Addresses

Primary practice location

480 Green Chapel Rd
Henning, TN 38041-5726

Mailing address

480 Green Chapel Rd
Henning, TN 38041-5726
Phone (901) 844-1434

Other providers in Henning, TN

All providers in Henning, TN · Family Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.