Jennifer D Judy, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

29873 Issued in TN

Practice address

2700 S Roan St Ste 300a
Johnson City, TN 37601-7556

Phone

(423) 491-9146

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Practice roles

Locations

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.

• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gray, TN
  • NPI 1720147408

  Single Specialty

  Medicare reassignment NPD
• Spark Integrative Wellness, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Johnson City, TN
  • NPI 1053121574

  Single Specialty

  NPD Authorized official
• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sneedville, TN
  • NPI 1053475558

  Single Specialty

  NPD
• Applegate Health Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bristol, VA
  • NPI 1730756131
  NPD (past)

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1326713280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S ROAN ST STE 300A",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017556",
            "telephone_number": "423-722-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S ROAN ST STE 300A",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017556",
            "telephone_number": "423-491-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2011 2nd St",
            "address_purpose": "LOCATION",
            "city": "Richlands",
            "state": "VA",
            "postal_code": "246412305",
            "country_code": "US",
            "telephone_number": "276-345-9900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3101 Lee Highway",
            "address_2": "#4325",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242015944",
            "country_code": "US",
            "telephone_number": "276-967-6000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "249 Central Park Ave Ste 300-161",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234623099",
            "country_code": "US",
            "telephone_number": "757-785-0500",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5511 Virginia Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277611",
            "country_code": "US",
            "telephone_number": "615-994-1000",
            "fax_number": "615-994-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2408 Susannah St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011765",
            "country_code": "US",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUDY",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024184531",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "233621",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "29873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Jordan, LPC
• Richard M Jordan, MD
• Joseph E. Bieberly, MD
• James Allen Joslyn, MD
• Ryan Kara Judson, NP
• Juhn and Stark LLC
• Brooke Julian
• Juliann Burks LMFT
• Anna K. Justice, A.N.P.
• Jack Claudious Justice III, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.