Individual provider Active NPI

Deborah K Jones

  • Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1164084307
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25647 Issued in TN
Practice address
1105 16TH Ave S
Nashville, TN 37212-2327
Phone
(615) 289-0033
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 25647 TN Primary

Addresses

Primary practice location

1105 16TH Ave S
Nashville, TN 37212-2327

Mailing address

1105 16TH Ave S
Nashville, TN 37212-2327
Phone (615) 289-0033

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL computer

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
I20210402000815 TN Practitioner - Nurse Practitioner 4880001155 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25647TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
An Insured Recovery, LLC CurrentSince Aug 1, 2023 Accepting new patients
Healing Waters Wellness Center, LLC PastSince Aug 1, 2023 Accepting new patients

Locations

839 Wren Rd
Goodlettsville, TN 37072
Phone (615) 330-0071

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1164084307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 16TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122327",
            "telephone_number": "615-289-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 16TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122327",
            "telephone_number": "615-289-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "25647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "address_1": "999 Girl Scout Rd",
            "city": "Burns",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370299065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.