Individual provider Active NPI

Jennifer McDonald-Beckley

  • Licensed Practical Nurse
  • Clarksville, TN
National Provider Identifier
1295188589
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0000057954 Issued in TN
Practice address
3419 Quicksilver LN
Clarksville, TN 37042-9524
Phone
(615) 474-1370
NPI assigned
Jul 21, 2016
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0000057954 TN Primary

Addresses

Primary practice location

3419 Quicksilver LN
Clarksville, TN 37042-9524

Mailing address

3419 Quicksilver LN
Clarksville, TN 37042-9524
Phone (615) 474-1370

Other identifiers 1

IdentifierTypeStateIssuer
0000057954OtherOHTENNESSEE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0000057954TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1295188589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 QUICKSILVER LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370429524",
            "telephone_number": "615-474-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 QUICKSILVER LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370429524",
            "telephone_number": "615-474-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD-BECKLEY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "0000057954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE BOARD OF NURSING",
            "identifier": "0000057954",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.