Leah Suzanne Jarrell, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APN0000012736 Issued in TN

Practice address

5602 Hunter Rd
Ooltewah, TN 37363-8746

Phone

(423) 785-7311

NPI assigned

Nov 18, 2012

Last updated

Nov 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Leah Suzanne Gibbs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1353196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353196800000",
    "number": "1194069948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 HUNTER RD",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373638746",
            "telephone_number": "423-785-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5602 HUNTER RD",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373638746",
            "telephone_number": "423-785-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "LEAH",
        "middle_name": "SUZANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-18",
        "last_updated": "2012-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN112452",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN0000012736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "GIBBS",
            "middle_name": "SUZANNE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Primary Care Nurse Practitioner in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.