Individual provider Active NPI

Jessica Nicole Null, FNP

  • Family Nurse Practitioner
  • Boone, NC
National Provider Identifier
1306481809
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5012509 Issued in NC
Practice address
240 Highway 105 Ext Ste 100
Boone, NC 28607-4291
Phone
(828) 264-7311
Fax
(828) 264-7907
NPI assigned
Nov 8, 2019
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 5012509 NC Primary

Addresses

Primary practice location

240 Highway 105 Ext Ste 100
Boone, NC 28607-4291

Mailing address

PO Box 1490
Boone, NC 28607-1490
Phone (828) 262-3886

Other practice location 1

200 Hospital Ave # 3
Jefferson, NC 28640-9244
Phone (336) 846-7433

Other practice location 2

560 Malcolm Blvd
Connelly Springs, NC 28612-7918
Phone (828) 874-2061

Other practice location 3

301 E Meeting St
Morganton, NC 28655-3593
Phone (828) 608-0800

Other practice location 4

935 State Farm Rd
Boone, NC 28607-4948
Phone (828) 262-3886

Other practice location 5

448 Cranberry St
Newland, NC 28657-8800
Phone (828) 737-0221

Other practice location 6

1925 N Bridge St Ste 101
Elkin, NC 28621-2105
Phone (336) 835-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200114000567 NC Practitioner - Nurse Practitioner 4981039328 Reassigns benefits to 2 organizations

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
Group practices
High Country Community HealthGroup PAC ID 8628225190, shared by 10 NPIs, 34 clinicians

Practice addresses (Care Compare)

240 Hwy 105 Ext
Suite 100
Boone, NC 28607-4291
Phone (828) 264-7311

935 State Farm Rd
Boone, NC 28607-4948
Phone (828) 262-3886

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5012509NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Community Health CurrentSince Oct 2, 2023 Accepting new patients
High Country Community Health CurrentSince Oct 2, 2023 Accepting new patients
High Country Community Health Family Medicine CurrentSince Oct 2, 2023 Accepting new patients
High Country Community Health Family Medicine Past Accepting new patients

Locations

160 Den-Mac Dr
Boone, NC 28607
Phone (828) 262-3886

240 Highway 105 Ext
Ste 100
Boone, NC 28607
Phone (828) 264-7311

935 State Farm Rd
Boone, NC 28607
Phone (828) 262-3886

560 Malcolm Blvd
Connelly Springs, NC 28612
Phone (828) 437-7702

1925 N Bridge St
#101
Elkin, NC 28621
Phone (336) 835-5330

448 Cranberry St
Newland, NC 28657
Phone (828) 737-0221

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJEBD

Organizations & group practices 4

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.

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": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1306481809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1490",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286071490",
            "telephone_number": "828-262-3886",
            "fax_number": "828-265-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HIGHWAY 105 EXT STE 100",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074291",
            "telephone_number": "828-264-7311",
            "fax_number": "828-264-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hospital Ave # 3",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "NC",
            "postal_code": "286409244",
            "country_code": "US",
            "telephone_number": "336-846-7433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Malcolm Blvd",
            "address_purpose": "LOCATION",
            "city": "Connelly Springs",
            "state": "NC",
            "postal_code": "286127918",
            "country_code": "US",
            "telephone_number": "828-874-2061",
            "fax_number": "888-232-8525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E Meeting St",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286553593",
            "country_code": "US",
            "telephone_number": "828-608-0800",
            "fax_number": "828-528-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 State Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074948",
            "country_code": "US",
            "telephone_number": "828-262-3886",
            "fax_number": "828-265-4816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "448 Cranberry St",
            "address_purpose": "LOCATION",
            "city": "Newland",
            "state": "NC",
            "postal_code": "286578800",
            "country_code": "US",
            "telephone_number": "828-737-0221",
            "fax_number": "828-737-0321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1925 N Bridge St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Elkin",
            "state": "NC",
            "postal_code": "286212105",
            "country_code": "US",
            "telephone_number": "336-835-7337",
            "fax_number": "336-835-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NULL",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5012509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.