Individual provider Active NPI

Jennifer Blair Massaro, APRN

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1194335018
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27935 Issued in TN
Practice address
1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605
Phone
(865) 909-0090
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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 27935 TN Primary

Addresses

Primary practice location

1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605

Mailing address

1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605
Phone (865) 909-0090

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
I20210302000469 TN Practitioner - Nurse Practitioner 6608282561

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1424 Whitower Dr
Knoxville, TN 37919-8841

7725 W Reno Ave
Suite 150
Oklahoma City, OK 73127-9711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27935TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC CurrentSince Feb 1, 2021 Accepting new patients

Locations

1900 N Winston Rd
Ste 501
Knoxville, TN 37919
Phone (865) 909-0090

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1194335018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N WINSTON RD STE 501",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193605",
            "telephone_number": "865-909-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N WINSTON RD STE 501",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193605",
            "telephone_number": "865-909-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSARO",
        "first_name": "JENNIFER",
        "middle_name": "BLAIR",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.