Individual provider Active NPI

Tina Marie Jones, FNP

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1568501096
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8128 Issued in TN
Practice address
3725 Champion Hills Dr
Suite 2000
Memphis, TN 38125-2597
Phone
(901) 367-9001
Fax
(901) 565-8787
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 129376 TN
Family Nurse Practitioner 363LF0000X 8128 TN Primary

Addresses

Primary practice location

3725 Champion Hills Dr
Suite 2000
Memphis, TN 38125-2597

Mailing address

6820 Old Bridge LN
Germantown, TN 38138-2661
Phone (018) 498-4409

Other names 1

  • Mrs. Tina Marie Dickinson 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
I20040721001548 TN Practitioner - Nurse Practitioner 8921088824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Group, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

2961 Canada Rd
Suite 105
Lakeland, TN 38002-4893
Phone (901) 388-0115

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129376TNMDFamily Nurse Practitioner
8128TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group LLC Family CurrentSince Sep 30, 2011 Accepting new patients

Locations

2961 Canada Rd
Ste 105
Lakeland, TN 38002
Phone (901) 388-0115

1211 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 287-5182

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

3725 Champion Hills Dr
Ste 2000
Memphis, TN 38125
Phone (901) 367-9001

Interoperability endpoints

  • Direct secure messaging: tjones34165@mlh.direct-ci.com

Organizations & group practices 1

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 6

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1568501096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 OLD BRIDGE LN",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382661",
            "telephone_number": "018-498-4409",
            "fax_number": "901-565-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 CHAMPION HILLS DR",
            "address_2": "SUITE 2000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252597",
            "telephone_number": "901-367-9001",
            "fax_number": "901-565-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "129376",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "8128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "DICKINSON",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.