Individual provider Active NPI

Jessica Nicole Roberts, APRN

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1619647153
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30276 Issued in TN
Practice address
6215 Humphreys Blvd Ste 301
Memphis, TN 38120-2382
Phone
(901) 227-9870
Fax
(901) 227-9879
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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 30276 TN Primary

Addresses

Primary practice location

6215 Humphreys Blvd Ste 301
Memphis, TN 38120-2382

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

6225 Humphreys Blvd
Memphis, TN 38120-2373
Phone (901) 227-2727

Other practice location 2

8138 Country Village Dr
Cordova, TN 38016-2029
Phone (901) 725-8606

Other practice location 3

6215 Humphreys Blvd Ste 301
Memphis, TN 38120-2382
Phone (901) 227-9870

Other practice location 4

2100 Exeter Rd
Germantown, TN 38138-3966
Phone (901) 757-1350

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
I20220504000261 TN Practitioner - Nurse Practitioner 8123415593 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30276TNMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1619647153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD STE 301",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202382",
            "telephone_number": "901-227-9870",
            "fax_number": "901-227-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6225 Humphreys Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202373",
            "country_code": "US",
            "telephone_number": "901-227-2727",
            "fax_number": "901-227-2477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8138 Country Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380162029",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "fax_number": "901-759-9254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6215 Humphreys Blvd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202382",
            "country_code": "US",
            "telephone_number": "901-227-9870",
            "fax_number": "901-226-1042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "fax_number": "901-757-3496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.