Jessica Erin Haltom, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71015418A Issued in IN

Practice address

101 Potters LN
Clarksville, IN 47129-1017

Phone

(443) 483-9300

NPI assigned

Jun 24, 2024

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 IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

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  • NPI 1750723490
  Medicare reassignment NPD
• Consonant Healing Associates of de LLC

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  • NPI 1669099321

  IN

  Medicare reassignment NPD
• Indiana Spine Group, PC

  • Orthopaedic Surgery of the Spine Physician
  • Carmel, IN
  • NPI 1609960046
  NPD (past)

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1548004500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIDGEBROOK RD STE 300",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529477",
            "telephone_number": "443-383-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 POTTERS LN",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471291017",
            "telephone_number": "443-483-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "IN",
            "postal_code": "460521972",
            "country_code": "US",
            "telephone_number": "765-481-1784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALTOM",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015418A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Gronefeld
• Elsa M Haddad, MD
• Theresa Hadley, FNP-C
• Rachael Haley, BCBA
• Wendy Hall
• Collyn Meredith Hamby, BA
• Lucas Hamelink, PHARMD
• Nathan James Hamilton, PHARMD
• Alex E Hammers, RBT
• Angel Hand

• Family Nurse Practitioner in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.