Individual provider Active NPI

Jessica Keeter, NP

  • Family Nurse Practitioner
  • Brentwood, TN
National Provider Identifier
1376302547
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10230181 Issued in TN
Practice address
9019 Overlook Blvd Ste C1
Brentwood, TN 37027-2736
Phone
(615) 274-9767
NPI assigned
Mar 18, 2024
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 F10230181 TN Primary

Addresses

Primary practice location

9019 Overlook Blvd Ste C1
Brentwood, TN 37027-2736

Mailing address

415 W 13TH St
Columbia, TN 38401-3621
Phone (256) 783-3208

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
I20240402000322 TN Practitioner - Nurse Practitioner 9931547502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iris Medical GroupGroup PAC ID 0648653360, 82 clinicians

Practice addresses (Care Compare)

9019 Overlook Blvd
Suite C1B
Brentwood, TN 37027-2737
Phone (615) 274-9767

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F10230181TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iris Medical Group Family CurrentSince Mar 1, 2024 Accepting new patients
Iris Wound Care, PC Past Accepting new patients

Locations

9019 Overlook Blvd
Ste C1
Brentwood, TN 37027

9019 Overlook Blvd
Ste C1B
Brentwood, TN 37027
Phone (769) 333-8808

Interoperability endpoints

  • Direct secure messaging: jessica.keeter.1@30029.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1376302547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W 13TH ST",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013621",
            "telephone_number": "256-783-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9019 OVERLOOK BLVD STE C1",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272736",
            "telephone_number": "615-274-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETER",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F10230181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.