Individual provider Active NPI

Jessica Ingle

  • Family Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1609469212
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27360 Issued in TN
Practice address
1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507
Phone
(423) 844-5520
NPI assigned
Feb 15, 2021
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 0024180158 VA
Family Nurse Practitioner 363LF0000X 27360 TN Primary

Addresses

Primary practice location

1 Medical Park Blvd Ste 205E
Bristol, TN 37620-7507

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other practice location 2

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210615001653 TN Practitioner - Nurse Practitioner 0840690756 Reassigns benefits to 2 organizations
I20210706000696 VA Practitioner - Nurse Practitioner 0840690756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians
WPS Providers IncGroup PAC ID 7719079532, 83 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Suite 250W
Bristol, TN 37620-7431
Phone (423) 844-6620

400 N State of Franklin Rd
FL 7
Johnson City, TN 37604-6035
Phone (423) 431-1592

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024180158VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WPS Providers Inc CurrentSince Dec 2, 2024 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Jul 4, 2021 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 4, 2021 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Jul 4, 2021 Accepting new patients
Blue Ridge Medical Management Corporation Family Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 205E
Bristol, TN 37620
Phone (423) 844-5520

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1 Medical Park Blvd
Ste 250W
Bristol, TN 37620
Phone (423) 844-6407

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

400 N State of Franklin Rd
Fl 7
Johnson City, TN 37604

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1609469212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 205E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207507",
            "telephone_number": "423-844-5520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGLE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180158",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.