Individual provider Active NPI

Jennifer R. Taylor, NP

  • Gerontology Nurse Practitioner
  • Abingdon, VA
National Provider Identifier
1487620274
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024166234 Issued in VA
Practice address
16000 Johnston Memorial Dr
Suite 313
Abingdon, VA 24211-7664
Phone
(276) 258-3780
Fax
(276) 258-3776
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024166234 VA Primary

Addresses

Primary practice location

16000 Johnston Memorial Dr
Suite 313
Abingdon, VA 24211-7664

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

16000 Johnston Memorial Dr Ste 112
Abingdon, VA 24211-7667
Phone (276) 258-3780

Other identifiers 4

IdentifierTypeStateIssuer
1487620274MedicaidVA
Q004987MedicaidTN
P01214685OtherRR MEDICARE
231160700OtherVADOL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041204000252 VA Practitioner - Nurse Practitioner 3870559594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Abingdon Physician Partners 39 clinicians
Blue Ridge Medical Management Corporation 283 clinicians

Practice addresses (Care Compare)

1205 Snider St
B
Marion, VA 24354-4221
Phone (276) 258-1777

16000 Johnson Memorial Dr
Abingdon, VA 24211-7664

323 Falls NWDR
Abingdon, VA 24210-8093
Phone (276) 628-2612

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Wise, VA, CCN 497288
  • Amedisys Home Health Care Home health agency, Abingdon, VA, CCN 497566
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Russell County Hospital Hospital, Lebanon, VA, CCN 490002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024166234VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Sep 1, 2011 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Abingdon Physician Partners CurrentSince Jan 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 1, 2011 Accepting new patients
Wellmont Physician Services Inc Past Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

16000 Johnston Memorial Dr
Ste 313
Abingdon, VA 24211
Phone (276) 258-3770

215 Valley St NE
Abingdon, VA 24210
Phone (276) 623-1332

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

1205 Snider St
#B
Marion, VA 24354
Phone (276) 258-1777

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1487620274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "address_2": "SUITE 313",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-3780",
            "fax_number": "276-258-3776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16000 Johnston Memorial Dr Ste 112",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117667",
            "country_code": "US",
            "telephone_number": "276-258-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "R.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024166234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487620274",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q004987",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01214685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "231160700",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.