Individual provider Active NPI

Nicole Sutton Jack

  • Occupational Therapist
  • Franklin, TN
National Provider Identifier
1194112532
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5861 Issued in TN
Practice address
3000 Edward Curd LN
Franklin, TN 37067-5791
Phone
(615) 791-2630
Fax
(615) 791-2639
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5861 TN Primary
Occupational Therapist 225X00000X OT006181 GA

Addresses

Primary practice location

3000 Edward Curd LN
Franklin, TN 37067-5791

Mailing address

3000 Edward Curd LN
Franklin, TN 37067-5791
Phone (615) 791-2630

Other practice location 1

804 Towne Park Dr
Suite 400
Rincon, GA 31326-5133
Phone (912) 826-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190918002373 TN Practitioner - Occupational Therapist in Private Practice 0345570321 Reassigns benefits to 1 organization
I20260325002008 NV Practitioner - Occupational Therapist in Private Practice 0345570321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Institute of Tennessee IncGroup PAC ID 9234491259, 86 clinicians

Practice addresses (Care Compare)

3000 Edward Curd LN
Franklin, TN 37067-5791
Phone (615) 790-7992

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
60.13
Promoting interoperability
99
Improvement activities
40
Cost
69.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT006181GAMDOccupational Therapist
5861TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bone and Joint Institute of Tennessee Inc CurrentSince Aug 1, 2019 Accepting new patients
Bone and Joint Institute of Tennessee Inc CurrentSince Aug 1, 2019 Accepting new patients
Hand Surgery Specialists of Nevada Young LLP Past Accepting new patients

Locations

101 Creekside Xing
Ste 1100
Brentwood, TN 37027
Phone (615) 791-2630

3000 Edward Curd Ln
Fl 1
Franklin, TN 37067

3000 Edward Curd Ln
Franklin, TN 37067
Phone (615) 791-2630

7216 Nolensville Rd
Ste 201
Nolensville, TN 37135
Phone (615) 791-2460

1106 Elliston Way
Ste 300
Thompsons Station, TN 37179
Phone (615) 791-2460

Organizations & group practices 3

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": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1194112532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 EDWARD CURD LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370675791",
            "telephone_number": "615-791-2630",
            "fax_number": "615-791-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 EDWARD CURD LN",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370675791",
            "telephone_number": "615-791-2630",
            "fax_number": "615-791-2639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Towne Park Dr",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Rincon",
            "state": "GA",
            "postal_code": "313265133",
            "country_code": "US",
            "telephone_number": "912-826-5450",
            "fax_number": "912-826-6413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTON JACK",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "5861",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.