Jacqueline D. Blanton, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

13405 Issued in TN

Practice address

1801 N Washington St
Ste. 300
Tullahoma, TN 37388-8245

Phone

(931) 393-4995

Fax

(931) 393-3573

NPI assigned

Mar 19, 2008

Last updated

Oct 29, 2013By the provider in NPPES

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates, PCGroup PAC ID 0840282000, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nephrology Associates, PC

  • Nephrology Physician
  • Nashville, TN
  • NPI 1700878360

  Acute Care

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1235300054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N WASHINGTON ST",
            "address_2": "STE. 300",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888245",
            "telephone_number": "931-393-4995",
            "fax_number": "931-393-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N WASHINGTON ST",
            "address_2": "STE. 300",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888245",
            "telephone_number": "931-393-4995",
            "fax_number": "931-393-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "JACQUELINE",
        "middle_name": "D.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "13405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamera Sue Bird
• Joel Stanley Birdwell, M.D.
• BKD Tullahoma, LLC (Brookdale Tullahoma)
• Mark Blair, M.D.
• James Harrell Blanks, OD
• Taylor Lanaux Blow, PAC
• Bluebird Recovery LLC
• Laurie Lynn Boland, M.A. CCC-SLP
• Jessica Nicole Bonar, MSN, APRN, AGACNP-BC
• Leanna Mashae Bonner

• Acute Care Nurse Practitioner in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.