JP Prime Health PLLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

JP PRIME HEALTH PLLC

Practice address

111 Ussery Rd
Clarksville, TN 37043-4530

Phone

(931) 647-0269

Fax

(931) 553-8129

NPI assigned

Jan 18, 2019

Organization subpart

No

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

Authorized official

Name

Jennifer Pendergrast, APN-BC

Title

NP

Phone

(931) 647-0269

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19067/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1346714714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 GLENRAVEN DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438296",
            "telephone_number": "931-436-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 USSERY RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434530",
            "telephone_number": "931-647-0269",
            "fax_number": "931-553-8129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 Glenraven Dr",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438296",
            "country_code": "US",
            "telephone_number": "931-647-0269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JP PRIME HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "PENDERGRAST",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "931-647-0269",
        "authorized_official_credential": "APN-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Adult Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.