Jessica Claire Shamblin, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12233 Issued in TN

Practice address

988 Oak Ridge Tpke Ste 200
Oak Ridge, TN 37830-6919

Phone

(865) 483-4366

NPI assigned

Sep 20, 2006

Last updated

Jun 24, 2020By 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

Other identifiers 3

Other names 1

• Jessica Claire Rasmussen Former name

Electronic endpoints 1

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shamblin.jessica@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488
  NPD (past)
• Express Health Clinic Corporation

  • Urgent Care Clinic/Center
  • Jefferson City, TN
  • NPI 1336189158
  NPD (past)
• Familycare Specialists PC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1033447008
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1265530620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 200",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306919",
            "telephone_number": "865-483-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 200",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306919",
            "telephone_number": "865-483-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "JESSICA",
        "middle_name": "CLAIRE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4155652",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q048117",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33438181",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Shamblin.Jessica@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "988 Oak Ridge Tpke Ste 200",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RASMUSSEN",
            "middle_name": "CLAIRE",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriela Serrano, MSSW
• Charles G Sewall, M.D.
• Gordon Scott Shafer, FNP-C, OPA-C, CSA
• Usama Shahbaz, MD
• Shama Home Health Care LLC
• James F. Shanks, MD
• Donald A Sharp, M.D.
• Sharon M Sharp
• Megan B Sheesley, LCSW
• Jesse Shelton

• Nurse Practitioner in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.