Jenna Carson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20935 Issued in TN

Practice address

1730 Old Gray Station Rd
Johnson City, TN 37615-3869

Phone

(423) 226-0954

NPI assigned

Apr 21, 2017

Sex

Female

Sole proprietor

Yes

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

Enrolled in TN, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of North Carolina at Chapel Hill School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emmaus Medical and Counseling, PLLCGroup PAC ID 1153673389, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenna.carson.p2@direct.alegiscare.nextgenshare.com

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.

• Emmaus Medical and Counseling, PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Bulls Gap, TN
  • NPI 1598256117
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1528593126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 OLD GRAY STATION RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153869",
            "telephone_number": "423-291-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 OLD GRAY STATION RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153869",
            "telephone_number": "423-226-0954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Mockingbird Ln Apt 202",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376043123",
            "country_code": "US",
            "telephone_number": "423-741-5422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Reed Cir",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376012982",
            "country_code": "US",
            "telephone_number": "423-741-5422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JENNA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas John Carroll, PA-C
• Quinton W Carroll, APRN
• Rachelle Renee Carroll, NP
• Timothy Scott Carruthers, D.C.
• Daniel Joseph Carson
• Teresa Keefauver Carson, R.D.H.
• Carter B Investments LLC
• Joely Ann Carter Way, F.N.P.-BC
• Alicia N Carter, LPC, MHSP
• Ginger Williams Carter, MD

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, 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 Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.