NPIMap

Organization Active NPI

MJ Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1578348256
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MJ MENTAL HEALTH, LLC
Practice address
4611 Asheville Hwy
Knoxville, TN 37914-3615
Phone
(865) 246-2104
Fax
(865) 246-2106
NPI assigned
Aug 30, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Jenna Frost, PMHNPNPI 1316425721
Title
MBR
Phone
(865) 306-7672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

4611 Asheville Hwy
Knoxville, TN 37914-3615

Mailing address

PO Box 5777
Maryville, TN 37802-5777
Phone (865) 246-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231023000159 TN Part B Supplier - Clinic/Group Practice 2163878513 Receives reassigned benefits from 12 practitioners

National Provider Directory

National Provider Directory

Locations

2989 Happy Valley Rd
Rossville, GA 30741
Phone (706) 916-2777

3382 Andersonville Hwy
Andersonville, TN 37705
Phone (732) 608-1388

7719 Shallowford Rd
Chattanooga, TN 37421
Phone (423) 296-0097

10520 Waterville Ln
Knoxville, TN 37932
Phone (865) 444-1451

1811 Little Creek Ln
Knoxville, TN 37922
Phone (865) 690-6727

307 N 5th St
Maryville, TN 37804
Phone (423) 983-0261

200 Bus Terminal Rd
Oak Ridge, TN 37830
Phone (828) 713-0560

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oneida Nursing & Rehab CenterOneida, TN, CCN 445254 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1578348256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5777",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025777",
            "telephone_number": "865-246-2104",
            "fax_number": "865-246-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 ASHEVILLE HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379143615",
            "telephone_number": "865-246-2104",
            "fax_number": "865-246-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "865-306-7672",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.