Individual provider Active NPI

Julie Ann Lepeak, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1154819662
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
24934 Issued in SC
Practice address
601 Cumberland St
Chattanooga, TN 37404-1922
Phone
(423) 266-6751
Fax
(423) 763-4742
NPI assigned
Apr 30, 2018
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 24934 SC Primary
Registered Nurse 163W00000X RN0000201924 TN

Addresses

Primary practice location

601 Cumberland St
Chattanooga, TN 37404-1922

Mailing address

362 N Pine St
Spartanburg, SC 29302-1631
Phone (864) 582-2817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20211028000655 SC Practitioner - Nurse Practitioner 6204169238 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenesis Organization Community Health CenterGroup PAC ID 8022928001, shared by 9 NPIs, 35 clinicians

Practice addresses (Care Compare)

301 Crescent Ave
Spartanburg, SC 29306-4143

750 S Church St
Spartanburg, SC 29306-5348
Phone (864) 582-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN0000201924TNMDRegistered Nurse
24934SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenesis Organization Community Health Center CurrentSince Aug 30, 2021 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Aug 30, 2021 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Aug 30, 2021 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Aug 30, 2021 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 11, 2022 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Aug 30, 2021 Accepting new patients
American Medical Response of Tennessee, Inc. Past Accepting new patients
Helen Ross McNabb Center PastSince Apr 20, 2013 Accepting new patients

Locations

301 Crescent Ave
Spartanburg, SC 29306
Phone (864) 582-2817

460 Langdon St
Spartanburg, SC 29302
Phone (864) 582-2817

750 S Church St
Spartanburg, SC 29306
Phone (864) 582-2829

115 Thomas St
#B
Union, SC 29379

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1154819662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021631",
            "telephone_number": "864-582-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CUMBERLAND ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041922",
            "telephone_number": "423-266-6751",
            "fax_number": "423-763-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPEAK",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "24934",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000201924",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.