Tracey Jolene Jenkins, FNP
Individual provider Active NPI Family Nurse Practitioner · Sale Creek, TN
NPI 1568918878 · NPPES record last updated Mar 24, 2017
Key facts
- NPI
- 1568918878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 21671 (TN)
- Practice address
- 14821 Dayton Pike
Sale Creek, TN 37373-5752 - Phone
- (423) 486-9455
- NPI assigned
- Aug 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Medical Clinic PLLC
Practice addresses (Care Compare)
791 New Hwy 68
Suite 1
Sweetwater, TN 37874-1906
Phone (423) 836-9304
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170419001748 | TN | Practitioner - Nurse Practitioner | 4587940952 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21671 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restoration Clinic | Family | Current |
Accepting new patients |
| Restoration Clinic | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Access Healthcare | Past | Accepting new patients | |
| First Care Family Clinic LLC | Past | Accepting new patients |
Locations
17619 State Highway 58 N
Ste C
Decatur, TN 37322
Phone (423) 334-2300
16850 State Highway 58 S
Ste B
Decatur, TN 37322
Phone (423) 507-7961
16850 State Highway 58 S
Ste A
Decatur, TN 37322
Phone (423) 334-2300
2019 Jacksboro Pike
La Follette, TN 37766
Phone (423) 437-3093
4008 Highway 411
Madisonville, TN 37354
Phone (423) 427-2402
1181 Dolly Parton Pkwy
Sevierville, TN 37862
Phone (865) 446-1433
791 New Highway 68
#1
Sweetwater, TN 37874
Phone (423) 836-9304
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21671 | TN | Yes |
Addresses
Primary practice location
14821 Dayton Pike
Sale Creek, TN 37373-5752
Mailing address
6130 Shallowford Rd
Ste 101
Chattanooga, TN 37421-7222
Phone (423) 664-4635
Other providers in Sale Creek, TN
- Daniel T Black
- First Care Family Clinic LLC
- Susan R Gasque
- Tyler Anthony Gunter
- Independent Physical Therapy
- Robert Lewis Kite
- Brook Janette Knight
- Ryan Danielle Miller
- Monyei Holdings Inc
- Whitney Lititia Ross
All providers in Sale Creek, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.