Active NPI
Julie A Jacques, DO
- Neurology Physician
- Morristown, TN
National Provider Identifier
1194775155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- DO1497
- Practice address
- 1907 W Morris Blvd
Healthstar Physicians Ste G
Morristown, TN 37813 - Phone
- (423) 318-0014
- Fax
- (423) 318-2595
- NPI assigned
- May 11, 2006
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | DO1497 | TN | Primary |
| Sleep Medicine (Psychiatry & Neurology) Physician | 2084S0012X | DO1497 | TN |
Addresses
Primary practice location
1907 W Morris Blvd
Healthstar Physicians Ste G
Morristown, TN 37813
Mailing address
1907 W Morris Blvd
Healthstar Physicians Ste G
Morristown, TN 37813
Phone (423) 318-0014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3307672 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO1497 | TN | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthstar Physicians PC | Past | Accepting new patients |
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.
-
- Pain Medicine (Anesthesiology) Physician
- Morristown, TN
- NPI 1841187648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1194775155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 W MORRIS BLVD",
"address_2": "HEALTHSTAR PHYSICIANS STE G",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "37813",
"telephone_number": "423-318-0014",
"fax_number": "423-318-2595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 W MORRIS BLVD",
"address_2": "HEALTHSTAR PHYSICIANS STE G",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "37813",
"telephone_number": "423-318-0014",
"fax_number": "423-318-2595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUES",
"first_name": "JULIE",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "DO1497",
"primary": true
},
{
"code": "2084S0012X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Sleep Medicine",
"state": "TN",
"license": "DO1497",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3307672",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morristown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.