Jaci Kate Qualls, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

38006 Issued in TN

Practice address

5751 Bradford Hicks Dr
Livingston, TN 38570-2237

Phone

(931) 823-3030

NPI assigned

Jan 16, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John R CloughGroup PAC ID 6103980305, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Livingston Regional Hospital Hospital, Livingston, TN, CCN 440187
• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaciquallsfnp@pcl-tn.direct.office.nextgen.com

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.

• John R Clough

  • Family Medicine Physician
  • Livingston, TN
  • NPI 1881870418
  Medicare reassignment Care Compare group NPD

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

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation
• Livingston Regional Hospital LLC

  • Rural Acute Care Hospital
  • Livingston, TN
  • NPI 1396760542
  Care Compare affiliation

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1194536367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 BRADFORD HICKS DR",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385702237",
            "telephone_number": "931-823-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 BRADFORD HICKS DR",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385702237",
            "telephone_number": "931-823-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "JACI",
        "middle_name": "KATE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "38006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Medicine Center of the Cumberlands
• Amy Powell
• Mark Douglas Pressley, DO, MPH
• Carrie Proffitt, CRT
• Luther Greene Puckett IV, D.D.S.
• Tiffany Quinlan
• Jamie Radcliff
• Laura Raines
• Ram K Thinakkal MD
• Mary Jo Ramsey, R.PH.

• Family Nurse Practitioner in Livingston, TN
• Providers in Livingston, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.
• 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.