Active NPI
Jennifer Stevens
- Family Nurse Practitioner
- Bristol, TN
National Provider Identifier
1194689653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024195596
- Practice address
- 1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507 - Phone
- (423) 844-5520
- Fax
- (423) 844-5521
- NPI assigned
- Dec 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024195596 | VA | Primary |
| Family Nurse Practitioner | 363LF0000X | 41520 | TN |
Addresses
Primary practice location
1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1021 W Oakland Ave
Suite 310
Johnson City, TN 37604-2192
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24195596 | VA | MD | Nurse Practitioner |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1194689653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-952-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK BLVD STE 205E",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376207507",
"telephone_number": "423-844-5520",
"fax_number": "423-844-5521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-10",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024195596",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "41520",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.