Jessica Boaz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000004527 Issued in TN

Practice address

317 Ebenezer Rd
Knoxville, TN 37923-5310

Phone

(865) 474-1490

Fax

(865) 999-7171

NPI assigned

Jul 19, 2021

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

Other names 1

• Jessie Boaz Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865

  TN

  Medicare reassignment NPD
• Faculty Physicians Knoxville, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Knoxville, TN
  • NPI 1205595360

  TN

  Medicare reassignment
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1205409117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 EBENEZER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235310",
            "telephone_number": "865-474-1490",
            "fax_number": "865-999-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 EBENEZER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235310",
            "telephone_number": "865-474-1490",
            "fax_number": "865-999-7171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7234 Tazewell Pike",
            "address_purpose": "LOCATION",
            "city": "Corryton",
            "state": "TN",
            "postal_code": "377213550",
            "country_code": "US",
            "telephone_number": "865-213-7132",
            "fax_number": "865-213-7133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 W Morris Blvd Ste 400A",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378132262",
            "country_code": "US",
            "telephone_number": "423-586-2410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7403 Middlebrook Pike",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379093110",
            "country_code": "US",
            "telephone_number": "865-500-6523",
            "fax_number": "865-500-6524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 Old Weisgarber Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379091381",
            "country_code": "US",
            "telephone_number": "865-588-1605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2435 Jacksboro Pike",
            "address_purpose": "LOCATION",
            "city": "LA Follette",
            "state": "TN",
            "postal_code": "377662910",
            "country_code": "US",
            "telephone_number": "423-449-8135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOAZ",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000004527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "BOAZ",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cody Bly, DO
• Mary Blythe
• Kimberly Marie Boamah
• Kelley Ashley Board
• Rozina Boatwright, REGISTERED NURSES
• Matthew Louis Bobbera, D.D.S
• Janine Lorraine Bobby, PT, DPT
• Katherine Elizabeth Bobinski
• Lindsay Bock, B.S.
• X-Zaviana Boddie

• All providers in Knoxville, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.