Individual provider Active NPI

Jamie Bare Vance, APRN

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1174033880
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23286 Issued in TN
Practice address
2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone
(423) 434-6677
Fax
(423) 461-0000
NPI assigned
Oct 8, 2017
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23286 TN Primary
Family Nurse Practitioner 363LF0000X 0024180262 VA
Family Nurse Practitioner 363LF0000X 5010105 NC

Addresses

Primary practice location

2408 Susannah St Ste 1
Johnson City, TN 37601-1765

Mailing address

2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone (423) 434-6677

Other practice location 1

137 Court St SE
Abingdon, VA 24210-3305
Phone (276) 477-1400

Other practice location 2

1725 Park Ave SW
Norton, VA 24273-1608
Phone (276) 409-5922

Other practice location 3

18948 US Highway 58
Castlewood, VA 24224-6032
Phone (276) 762-2172

Other practice location 4

1662 Bonham Rd
Bristol, VA 24201-2090
Phone (276) 644-9899

Other practice location 5

2011 2nd St
Richlands, VA 24641-2305
Phone (276) 345-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180124000542 NC Practitioner - Nurse Practitioner 5799044533
I20200328000140 TN Practitioner - Nurse Practitioner 5799044533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

2686 W State St
Bristol, TN 37620-1817
Phone (423) 844-0026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates Inc CurrentSince Apr 12, 2020 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Apr 12, 2020 Accepting new patients
Blue Ridge Medical Management Corporation Family Past Accepting new patients

Locations

2686 W State St
Bristol, TN 37620
Phone (423) 844-0026

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

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

405 Scenic Dr
Ste A
Rogersville, TN 37857
Phone (423) 272-2111

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": "1507420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1174033880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 Court St SE",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242103305",
            "country_code": "US",
            "telephone_number": "276-477-1400",
            "fax_number": "276-477-1404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1725 Park Ave SW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731608",
            "country_code": "US",
            "telephone_number": "276-409-5922",
            "fax_number": "276-409-5923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18948 US Highway 58",
            "address_purpose": "LOCATION",
            "city": "Castlewood",
            "state": "VA",
            "postal_code": "242246032",
            "country_code": "US",
            "telephone_number": "276-762-2172",
            "fax_number": "276-762-5039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1662 Bonham Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242012090",
            "country_code": "US",
            "telephone_number": "276-644-9899",
            "fax_number": "276-644-9978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2011 2nd St",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "VA",
            "postal_code": "246412305",
            "country_code": "US",
            "telephone_number": "276-345-9900",
            "fax_number": "276-345-9901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JAMIE",
        "middle_name": "BARE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-08",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23286",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180262",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.