Individual provider Active NPI

Jena Elise Hutson, MSN, FNP-BC

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1164856969
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17869 Issued in TN
Practice address
111 W Stone Dr Ste 310
Kingsport, TN 37660-6030
Phone
(423) 398-7020
NPI assigned
Aug 28, 2013
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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 17869 TN Primary

Addresses

Primary practice location

111 W Stone Dr Ste 310
Kingsport, TN 37660-6030

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

1335 E Center St
#1
Kingsport, TN 37664-2489
Phone (423) 247-2263

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
I20131204001431 TN Practitioner - Nurse Practitioner 4082840657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

111 W Stone Dr
Suite 310
Kingsport, TN 37660-6030
Phone (423) 398-7020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Jun 11, 2015 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Jun 11, 2015 Accepting new patients
Blue Ridge Medical Management Corporation Family Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

111 W Stone Dr
Ste 310
Kingsport, TN 37660
Phone (423) 398-7020

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 224-3100

Organizations & group practices 4

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": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1164856969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR STE 310",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606030",
            "telephone_number": "423-398-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 E Center St",
            "address_2": "#1",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376642489",
            "country_code": "US",
            "telephone_number": "423-247-2263",
            "fax_number": "423-246-1943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "JENA",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.