Active NPI
Jennifer Michelle Barham, NP-C
- Dermatology Physician
- New York, NY
National Provider Identifier
1316245137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 7770247
- Practice address
- 300 E 56TH St Apt 3C
New York, NY 10022-4135 - Phone
- (516) 210-5600
- Fax
- (917) 254-4419
- NPI assigned
- Mar 2, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15635 | TN | |
| Dermatology Physician | 207N00000X | 7770247 | TN | Primary |
Addresses
Primary practice location
300 E 56TH St Apt 3C
New York, NY 10022-4135
Mailing address
305 Appleberry Cir
Kingsport, TN 37663-3389
Phone (423) 502-2134
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- East Tennessee State University Quillen College of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2421 W 21St St
Suite B
Clovis, NM 88101-2006
Phone (575) 769-7577
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80241 | NM | MD | Dermatology Physician |
| 7770247 | TN | MD | Dermatology Physician |
| 15635 | TN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Dermatology Associates, P.C. | Dermatology | Current | Accepting new patients |
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Locations
2421 W 21st St
Ste B
Clovis, NM 88101
Phone (575) 742-7824
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
2300 W Stone Dr
Kingsport, TN 37660
Phone (423) 246-4961
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- Dermatology Physician
- Kingsport, TN
- NPI 1487695862
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Critical Access Hospital
- Taos, NM
- NPI 1902338049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1316245137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 APPLEBERRY CIR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376633389",
"telephone_number": "423-502-2134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E 56TH ST APT 3C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100224135",
"telephone_number": "516-210-5600",
"fax_number": "917-254-4419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARHAM",
"first_name": "JENNIFER",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-02",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "15635",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TN",
"license": "7770247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.