Individual provider Active NPI

Jacob Lay, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Powell, TN
National Provider Identifier
1477216281
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
30389 Issued in TN
Practice address
7714 Conner Rd Ste 105
Powell, TN 37849-3559
Phone
(865) 947-6220
Fax
(865) 512-1069
NPI assigned
Oct 19, 2021
Last updated
Oct 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30389 TN Primary

Addresses

Primary practice location

7714 Conner Rd Ste 105
Powell, TN 37849-3559

Mailing address

1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344

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
I20211209001500 TN Practitioner - Nurse Practitioner 6507256351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Health SystemsGroup PAC ID 3577474295, 128 clinicians

Practice addresses (Care Compare)

2018 Western Ave
Knoxville, TN 37921-5718
Phone (423) 317-9344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30389TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems CurrentSince Oct 25, 2021 Accepting new patients
Cherokee Health Systems CurrentSince Oct 25, 2021 Accepting new patients

Locations

2018 Western Ave
Knoxville, TN 37921
Phone (865) 544-0406

1923 Sulphur Springs Rd
Morristown, TN 37813

7714 Conner Rd
Ste 105
Powell, TN 37849
Phone (865) 947-6220

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Interoperability endpoints

  • Direct secure messaging: jacob.lay.p1@direct.cherokeehealth.nextgenshare.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.

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1477216281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7714 CONNER RD STE 105",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378493559",
            "telephone_number": "865-947-6220",
            "fax_number": "865-512-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAY",
        "first_name": "JACOB",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, TN

Sources for this page

Verify at the official NPI Registry.