Individual provider Active NPI

Jessica R Chittum, FNP-BC

  • Family Nurse Practitioner
  • Cumberland Gap, TN
National Provider Identifier
1255985396
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0000026201 Issued in TN
Practice address
779 Highway 63 Ste 1
Cumberland Gap, TN 37724-4116
Phone
(423) 919-9886
Fax
(423) 919-9887
NPI assigned
Jul 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000026201 TN Primary

Addresses

Primary practice location

779 Highway 63 Ste 1
Cumberland Gap, TN 37724-4116

Mailing address

PO Box 119
Harrogate, TN 37752-0119
Phone (423) 489-2300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909000761 TN Practitioner - Nurse Practitioner 8628307279

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2435 Jacksboro Pike a
La Follete, TN 37766-2910

435 S Yonge St
Suite 2
Ormond Beach, FL 32174-7592

6100 Bandera Rd
Suite 215
San Antonio, TX 78238-1607

951 N Broad St
Tazewell, TN 37879-4323

Hospital & facility affiliations

  • Claiborne Medical Center Hospital, Tazewell, TN, CCN 440057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000026201TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Healthcare CurrentSince Feb 23, 2021 Accepting new patients

Locations

779 Highway 63
Ste 1
Cumberland Gap, TN 37724
Phone (423) 919-9886

2210 Highway 63
Cumberland Gap, TN 37724
Phone (423) 919-9886

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1255985396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377520119",
            "telephone_number": "423-489-2300",
            "fax_number": "423-919-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 HIGHWAY 63 STE 1",
            "city": "CUMBERLAND GAP",
            "state": "TN",
            "postal_code": "377244116",
            "telephone_number": "423-919-9886",
            "fax_number": "423-919-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITTUM",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000026201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland Gap, TN

Sources for this page

Verify at the official NPI Registry.