Individual provider Active NPI

Rosemary Jacobs, MSN FNP BC

  • Family Nurse Practitioner
  • Millington, TN
National Provider Identifier
1407026446
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13302 Issued in TN
Practice address
8510 Wilkinsville Rd
104
Millington, TN 38053
Phone
(901) 872-3114
Fax
(901) 872-3114
NPI assigned
Mar 5, 2008
Last updated
May 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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 13302 TN Primary

Addresses

Primary practice location

8510 Wilkinsville Rd
104
Millington, TN 38053

Mailing address

8510 Wilkinsville Rd
Suite 104
Millington, TN 38053-1537
Phone (901) 872-3114

Other practice location 1

8507 US Highway 51 N Ste 107
Millington, TN 38053-1535
Phone (901) 873-2555

Other identifiers 2

IdentifierTypeStateIssuer
1700227436OtherTNGROUP NPI
1513105MedicaidTN

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
I20081216000063 TN Practitioner - Nurse Practitioner 4284796863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

8510 Wilkinsville Rd
Suite 104
Millington, TN 38053-1538
Phone (901) 872-3114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13302TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Blakney Current Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 26, 2013 Accepting new patients
Saint Francis Physician Network, LLC CurrentSince Feb 5, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 26, 2013 Accepting new patients
Health First Urgent Care Clinic Current Accepting new patients

Locations

8025 US Highway 64
Ste 101
Bartlett, TN 38133
Phone (901) 382-2044

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

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

8507 US Highway 51 N
Ste 107
Millington, TN 38053
Phone (901) 873-2555

8510 Wilkinsville Rd
Ste 104
Millington, TN 38053
Phone (901) 872-3114

Interoperability endpoints

  • Direct secure messaging: rosemary.jacobs.1@16700.direct.athenahealth.com

Organizations & group practices 6

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 8

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": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1407026446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 WILKINSVILLE RD",
            "address_2": "SUITE 104",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531537",
            "telephone_number": "901-872-3114",
            "fax_number": "901-872-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 WILKINSVILLE RD",
            "address_2": "104",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "38053",
            "telephone_number": "901-872-3114",
            "fax_number": "901-872-3114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8507 US Highway 51 N Ste 107",
            "address_purpose": "LOCATION",
            "city": "Millington",
            "state": "TN",
            "postal_code": "380531535",
            "country_code": "US",
            "telephone_number": "901-873-2555",
            "fax_number": "901-873-2561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ROSEMARY",
        "credential": "MSN FNP BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1700227436",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513105",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millington, TN

Sources for this page

Verify at the official NPI Registry.