Individual provider Active NPI

Jennifer King, NP-C

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1659829521
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21704 Issued in TN
Practice address
6027 Walnut Grove Rd
Memphis, TN 38120-2145
Phone
(901) 747-1007
NPI assigned
Sep 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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 21704 TN Primary

Addresses

Primary practice location

6027 Walnut Grove Rd
Memphis, TN 38120-2145

Mailing address

7600 Wolf River Blvd
#200
Germantown, TN 38138-1785
Phone (901) 747-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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
I20161110002673 TN Practitioner - Nurse Practitioner 1355620584 Reassigns benefits to 3 organizations
I20170726003622 MS Practitioner - Nurse Practitioner 1355620584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

1500 W Poplar Ave
Collierville, TN 38017-0601
Phone (901) 861-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21704TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Sep 1, 2018 Accepting new patients
Wound Management Specialists, LLC CurrentSince Dec 5, 2021 Accepting new patients
Winston Medical Clinic LLC PastSince Dec 5, 2021 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

1190 N State St
Ste 2A
Jackson, MS 39202
Phone (601) 292-4292

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 4

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": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1659829521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD",
            "address_2": "#200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381785",
            "telephone_number": "901-747-1000",
            "fax_number": "901-747-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6027 WALNUT GROVE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202145",
            "telephone_number": "901-747-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JENNIFER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.