Individual provider Active NPI

Jackie Susnne Winfrey, APN

  • Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1629271028
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19955 Issued in TN
Practice address
341 Wallace Rd Ste D
Nashville, TN 37211-8001
Phone
(615) 832-2200
Fax
(615) 832-2020
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4298617 TN
Nurse Practitioner 363L00000X 19955 TN Primary

Addresses

Primary practice location

341 Wallace Rd Ste D
Nashville, TN 37211-8001

Mailing address

341 Wallace Rd Ste D
Nashville, TN 37211-8001
Phone (615) 832-2200

Other practice location 1

3050 Business Park Cir Ste 101
Goodlettsville, TN 37072-3588
Phone (615) 855-0202

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
I20170802000019 TN Practitioner - Nurse Practitioner 7810268315 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
Metropolitan Hospital AuthorityGroup PAC ID 3779775432, 50 clinicians

Practice addresses (Care Compare)

1818 Albion St
Nashville, TN 37208-2918
Phone (615) 341-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4298617TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Authority CurrentSince May 15, 2024 Accepting new patients

Locations

131 French Landing Dr
Ste B
Nashville, TN 37228
Phone (615) 256-6210

4007 Clarksville Pike
Nashville, TN 37218
Phone (615) 341-4968

1818 Albion St
Nashville, TN 37208
Phone (615) 341-4000

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 1

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629271028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WALLACE RD STE D",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118001",
            "telephone_number": "615-832-2200",
            "fax_number": "615-832-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 WALLACE RD STE D",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118001",
            "telephone_number": "615-832-2200",
            "fax_number": "615-832-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3050 Business Park Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Goodlettsville",
            "state": "TN",
            "postal_code": "370723588",
            "country_code": "US",
            "telephone_number": "615-855-0202",
            "fax_number": "615-859-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINFREY",
        "first_name": "JACKIE",
        "middle_name": "SUSNNE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "4298617",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "19955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.