Individual provider Active NPI

Kyona Olatunji, NP

  • Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1144813700
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28925 Issued in TN
Practice address
700 W Forest Ave FL 4
Jackson, TN 38301-3937
Phone
(731) 541-2250
NPI assigned
Feb 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28925 TN
Nurse Practitioner 363L00000X 28925 TN Primary

Addresses

Primary practice location

700 W Forest Ave FL 4
Jackson, TN 38301-3937

Mailing address

700 W Forest Ave FL 4
Jackson, TN 38301-3937
Phone (731) 541-2250

Other practice location 1

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

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
I20210827001216 TN Practitioner - Nurse Practitioner 5890190961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

569 Skyline Dr
Jackson, TN 38301-3911
Phone (731) 421-6510

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28925TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Sep 23, 2024 Accepting new patients
Kidney Experts PLLC CurrentSince Jun 21, 2021 Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

1575 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 286-1510

1718 Parr Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-5121

569 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

700 W Forest Ave
Ste 4
Jackson, TN 38301

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

160 W University Pkwy
Ste Cd
Jackson, TN 38305

700 W Forest Ave
Fl 4
Jackson, TN 38301
Phone (731) 541-0240

160 W University Pkwy
Ste C
Jackson, TN 38305
Phone (731) 286-1510

700 W Forest Ave
Ste 44
Jackson, TN 38301

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

405 Tyson Ave
Paris, TN 38242
Phone (731) 394-3499

103A Jane St
Paris, TN 38242

270 E Court Ave
#B
Selmer, TN 38375
Phone 73164579322931

Organizations & group practices 3

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": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1144813700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE FL 4",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-541-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W FOREST AVE FL 4",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013937",
            "telephone_number": "731-541-2250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013923",
            "country_code": "US",
            "telephone_number": "731-541-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLATUNJI",
        "first_name": "KYONA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28925",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "28925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.