Individual provider Active NPI

Jenica A Lamar, FNP

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1366054934
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27964 Issued in TN
Practice address
701 Morganton Square Dr
Maryville, TN 37801-4796
Phone
(865) 982-7101
Fax
(833) 908-2132
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 27964 TN
Family Nurse Practitioner 363LF0000X 27964 TN Primary

Addresses

Primary practice location

701 Morganton Square Dr
Maryville, TN 37801-4796

Mailing address

PO Box 26194
Belfast, ME 04915-2012
Phone (865) 584-4747

Other practice location 1

6606 Clinton Hwy
Knoxville, TN 37912-1016
Phone (865) 684-4022

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
I20201223001571 TN Practitioner - Nurse Practitioner 6204248834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

701 Morganton Square Dr
Maryville, TN 37801-4796
Phone (865) 982-7101

Hospital & facility affiliations

  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27964TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well-Key Health, PLLC CurrentSince Sep 1, 2020 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 11, 2023 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 11, 2023 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients

Locations

6606 Clinton Hwy
Knoxville, TN 37912
Phone (865) 428-2773

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

701 Morganton Square Dr
Maryville, TN 37801
Phone (865) 982-7101

1787 Veterans Blvd
Ste 101
Sevierville, TN 37862
Phone (865) 428-2773

Interoperability endpoints

  • Direct secure messaging: jenica.lamar.1@20785.direct.athenahealth.com

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.

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1366054934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26194",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152012",
            "telephone_number": "865-584-4747",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014796",
            "telephone_number": "865-982-7101",
            "fax_number": "833-908-2132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6606 Clinton Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379121016",
            "country_code": "US",
            "telephone_number": "865-684-4022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMAR",
        "first_name": "JENICA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "27964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.