Individual provider Active NPI

Jennifer Rebecca Whitlock, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1609285683
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18901 Issued in TN
Practice address
2515 Desales Ave Ste 206
Chattanooga, TN 37404-1100
Phone
(423) 698-8101
Fax
(423) 698-3450
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18901 TN Primary

Addresses

Primary practice location

2515 Desales Ave Ste 206
Chattanooga, TN 37404-1100

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

Other practice location 1

1651 Gunbarrel Rd Ste 102
Chattanooga, TN 37421-3289
Phone (423) 308-0390

Other names 1

  • Jennifer Rebecca Heisler 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
I20141022001659 TN Practitioner - Nurse Practitioner 6002037728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Medical Group, PCGroup PAC ID 2668377391, 122 clinicians

Practice addresses (Care Compare)

2515 Desales Ave
Suite 206
Chattanooga, TN 37404-1100
Phone (423) 698-8101

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group, PC Family CurrentSince Feb 17, 2020 Accepting new patients

Locations

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

1651 Gunbarrel Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 308-0292

2515 Desales Ave
Ste 206
Chattanooga, TN 37404
Phone (423) 629-6550

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

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 3

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": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1609285683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DESALES AVE STE 206",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041100",
            "telephone_number": "423-698-8101",
            "fax_number": "423-698-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 Gunbarrel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374213289",
            "country_code": "US",
            "telephone_number": "423-308-0390",
            "fax_number": "423-308-0393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "JENNIFER",
        "middle_name": "REBECCA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HEISLER",
            "middle_name": "REBECCA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.