Individual provider Active NPI

James Lee Poindexter, APRN BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1407044670
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0017138989 Issued in VA
Practice address
782 Weatherly Dr
Clarksville, TN 37043-8941
Phone
(931) 645-3552
NPI assigned
Oct 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 0015000843 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0017138989 VA Primary

Addresses

Primary practice location

782 Weatherly Dr
Clarksville, TN 37043-8941

Mailing address

782 Weatherly Dr
Clarksville, TN 37043-8941
Phone (804) 380-4581

Other practice location 1

1832 Memorial Dr
Clarksville, TN 37043-6311
Phone (931) 645-3552 ext. 64041

Other practice location 2

8133 Forest Hill Ave
Suite 102
Richmond, VA 23235-3254
Phone (804) 380-4581

Other identifiers 1

IdentifierTypeStateIssuer
1619042173OtherNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0017138989VAMDPsychiatric/Mental Health Nurse Practitioner
0015000843VAMDPsychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407044670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438941",
            "telephone_number": "804-380-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438941",
            "telephone_number": "931-645-3552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1832 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370436311",
            "country_code": "US",
            "telephone_number": "931-645-3552 x64041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8133 Forest Hill Ave",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232353254",
            "country_code": "US",
            "telephone_number": "804-380-4581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POINDEXTER",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0015000843",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0017138989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1619042173",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.