Individual provider Active NPI

Jade Lee Wilkie

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1356990980
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26290 Issued in TN
Practice address
3109 Walnut Grove Rd
Memphis, TN 38111-3509
Phone
(901) 515-4800
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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 26290 TN Primary

Addresses

Primary practice location

3109 Walnut Grove Rd
Memphis, TN 38111-3509

Mailing address

4971 Chickasaw Rd
Memphis, TN 38117-2001
Phone (501) 538-3294

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191121002822 TN Practitioner - Nurse Practitioner 3779915269 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26290TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Blakney Current Accepting new patients
Saint Francis Physician Network, LLC CurrentSince Feb 24, 2020 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Oct 28, 2019 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Oct 28, 2019 Accepting new patients

Locations

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

6005 Park Ave
Ste 323B
Memphis, TN 38119
Phone (901) 756-6991

3109 Walnut Grove Rd
Memphis, TN 38111
Phone (901) 458-0162

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.

NPI Registry JSON

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1356990980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 CHICKASAW RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381172001",
            "telephone_number": "501-538-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381113509",
            "telephone_number": "901-515-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "JADE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.