Jenni Marie O'Malley, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

8896 Issued in SC

Practice address

1105 W Stone Dr Ste 5
Kingsport, TN 37660-2558

Phone

(423) 224-5697

NPI assigned

Dec 1, 2011

Last updated

Oct 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD

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.

• Beaufort Jasper Hampton Comprehensive Health Services, Inc.

  dba BJHCHS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ridgeland, SC
  • NPI 1649276148
  Medicare reassignment NPD
• Beaufort Jasper Hampton Comprehensive Health Services, Inc

  dba Varnville Medical Center

  • Federally Qualified Health Center (FQHC)
  • Varnville, SC
  • NPI 1073318259
  NPD
• Abc Family Dentistry PLLC

  • General Practice Dentistry
  • Greeneville, TN
  • NPI 1790920650
  NPD (past)
• Welvista

  dba Allendale Smiles for a Lifetime

  • General Practice Dentistry
  • Fairfax, SC
  • NPI 1033290937
  NPD (past)

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1609144997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 CATTAIL PT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376019404",
            "telephone_number": "407-791-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W STONE DR STE 5",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602558",
            "telephone_number": "423-224-5697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454037",
            "country_code": "US",
            "telephone_number": "423-639-2176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1409 W Market St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046005",
            "country_code": "US",
            "telephone_number": "423-926-1922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "JENNI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27456",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11246",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "21809",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8896",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaddeus Lorenzo Noto, M.DIV., L.P.C.
• Diana Nunley, M.D.
• Terry R Nye, MD
• Brittney O'Hara, NP-C
• Mary Kathleen O'Keeffe, MA, LMFT
• Brian Andrew O'Neal, D.O. , MPH
• Glenda K O'Neal, CCC-SLP
• Chastity M O'Quinn, RD
• James Clyde Oaks, PTA
• Wendy Tipton Oberdick, MD

• Dentist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.