Jared Sheldon Penner

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

34243 Issued in TN

Practice address

2205 McCallie Ave
Chattanooga, TN 37404-3230

Phone

(423) 698-2435

NPI assigned

Jul 7, 2023

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jarred.penner@hca1.eclinicaldirectplus.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.

• Chattanooga Diagnostic Associates LLC

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1679772099
  Medicare reassignment NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1235817529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SUMMER DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307363258",
            "telephone_number": "928-358-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 MCCALLIE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043230",
            "telephone_number": "423-698-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "JARED",
        "middle_name": "SHELDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-10-04",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "34243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Pelland, LMHC, LPCMHSP, LCMHC
• Daniel Pelts, MA
• Miguel Alejandro Penaherrera Oviedo, M.D.
• Alyssa Grace Pendergrass
• Joseph Raymond Pendley, D.O.
• Nina Drucilla Pennewell, PH.D.
• Pennie Jo Leggett
• Ross Vincent Penny, AASMT,LMT,CNMT
• Janera Pentiah
• Linda Lee Peoples, PHD LPC RN

• Psychiatric/Mental Health Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.