Jessica Ellam, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22195 Issued in TN

Practice address

200 New York Ave
Suite 150
Oak Ridge, TN 37830-5212

Phone

(865) 835-5196

Fax

(865) 835-5197

NPI assigned

Jan 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Sr Medical Services, LLC

  • Internal Medicine Physician
  • Caryville, TN
  • NPI 1679718662
  NPD (past)

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1447797808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE",
            "address_2": "SUITE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305212",
            "telephone_number": "865-835-5196",
            "fax_number": "865-835-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE",
            "address_2": "SUITE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305212",
            "telephone_number": "865-835-5196",
            "fax_number": "865-835-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLAM",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Raymond Eckert, D.C.
• Janet Edwards, AU.D.
• Elcm Oak Ridge Leasing LLC
• Elcm Oak Ridge Management LLC
• Elite Pain Consultants, PLLC
• Alicia Ellis, NP
• Seta Lamallari Ellis, DO
• Jesse Ellsworth, DMD
• Emory Valley Center
• Endocrine Associates, P.C.

• Family Nurse Practitioner in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.