Individual provider Active NPI

Jessica Marie Ellis, CPNP-AC

  • Acute Care Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1558078709
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
37542 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-3962
Phone
(615) 322-5000
NPI assigned
Oct 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 37542 TN
Pediatric Registered Nurse 163WP0200X 252633 TN
Acute Care Nurse Practitioner 363LA2100X 37542 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-3962

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 322-6842

Other practice location 1

2200 Childrens Way
Nashville, TN 37232-3962
Phone (847) 648-6592

Other identifiers 2

IdentifierTypeStateIssuer
7101028620MedicaidKY
Q098720MedicaidTN

Other names 1

  • Jessica Marie Huenecke 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108001679 TN Practitioner - Nurse Practitioner 4183152945 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
252633TNMDPediatric Registered Nurse
37542TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center CurrentSince Jan 28, 2025 Accepting new patients
Vanderbilt University Past Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

2200 Childrens Way
Ste 4202
Nashville, TN 37232
Phone (615) 343-5875

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

2200 Childrens Way
Nashville, TN 37232
Phone (615) 322-3023

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

Interoperability endpoints

  • Direct secure messaging: jhuenecke634849@direct.vumc.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757203200000",
    "number": "1558078709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-322-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372323962",
            "telephone_number": "615-322-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372323962",
            "country_code": "US",
            "telephone_number": "847-648-6592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2025-09-07",
        "certification_date": "2025-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "37542",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TN",
            "license": "252633",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "37542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101028620",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q098720",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HUENECKE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.