Active NPI
Frances A. Jackson, FNP, CS
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- Johnson City, TN
National Provider Identifier
1639109697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- License
- APN06486
- Practice address
- 109 W Watauga Ave
Johnson City, TN 37604-5621 - Phone
- (423) 232-2600
- Fax
- (423) 232-2646
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN06486 | TN | |
| Adult Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0809X | APN06486 | TN | Primary |
Addresses
Primary practice location
109 W Watauga Ave
Johnson City, TN 37604-5621
Mailing address
1167 Spratlin Drive
Gray, TN 37615-6205
Phone (423) 467-3600
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4004827 | Other | TN | BLUECROSSBLUESHIELD |
| 3343432 | Medicaid | TN | |
| 100036825 | Other | TN | PHP |
| TN01D7 | Other | TN | JOHN DEERE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN06486 | TN | MD | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500508800000",
"number": "1639109697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1167 SPRATLIN DRIVE",
"city": "GRAY",
"state": "TN",
"postal_code": "376156205",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W WATAUGA AVE",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376045621",
"telephone_number": "423-232-2600",
"fax_number": "423-232-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "FRANCES",
"middle_name": "A.",
"credential": "FNP, CS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2017-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "APN06486",
"primary": false
},
{
"code": "364SP0809X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
"state": "TN",
"license": "APN06486",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD",
"identifier": "4004827",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3343432",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "100036825",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN01D7",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.