Individual provider Active NPI

Jennifer Nicole Justice

  • Student in an Organized Health Care Education/Training Program
  • Chattanooga, TN
National Provider Identifier
1548901986
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
910 Blackford St
Chattanooga, TN 37403-1405
Phone
(423) 778-6217
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

910 Blackford St
Chattanooga, TN 37403-1405

Mailing address

910 Blackford St
Chattanooga, TN 37403-1405

Other names 1

  • Jennifer Nicole White Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260228001001 TN Practitioner - Pediatric Medicine 2668859794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

900 E 3Rd St
Chattanooga, TN 37403-2101

975 E 3Rd St Box
Suite 159
Chattanooga, TN 37403-2163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6444TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Erlanger Health CurrentSince Mar 1, 2026 Accepting new patients
Erlanger Health CurrentSince Mar 1, 2026 Accepting new patients

Locations

900 E 3rd St
Chattanooga, TN 37403
Phone (423) 778-5437

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1548901986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WHITE",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.