Individual provider Active NPI

Jennifer P Roop, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1669761680
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3617 Issued in TN
Practice address
11416 Grigsby Chapel Rd Ste 100
Knoxville, TN 37934-1649
Phone
(865) 675-8000
Fax
(865) 524-0224
NPI assigned
Mar 30, 2011
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3617 TN Primary
Surgical Physician Assistant 363AS0400X PA9105939 FL

Addresses

Primary practice location

11416 Grigsby Chapel Rd Ste 100
Knoxville, TN 37934-1649

Mailing address

PO Box 23329
New York, NY 10087-3329

Other identifiers 1

IdentifierTypeStateIssuer
Q038444MedicaidTN

Other names 1

  • Miss Jennifer Lauren Prescott Former name

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
I20181127000275 TN Practitioner - Physician Assistant 0244400661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Dermatology Group PCGroup PAC ID 8123009636, 29 clinicians

Practice addresses (Care Compare)

11416 Grigsby Chapel Rd
Suite 100
Knoxville, TN 37934-1649
Phone (865) 524-2547

123 Fox Rd
Knoxville, TN 37922-3369
Phone (865) 690-9467

1450 Dowell Springs Blvd
Suite 210
Knoxville, TN 37909-2448
Phone (865) 524-2547

7557 Dannaher Dr
Suite G20
Powell, TN 37849-1517
Phone (865) 524-2547

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3617TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Knoxville, PC PastSince Aug 1, 2019 Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Southern Dermatology, P.a. Past Accepting new patients
East Tennessee Dermatology Group, PC PastSince Oct 1, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jwebster@aadermaffiliates.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1669761680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11416 GRIGSBY CHAPEL RD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341649",
            "telephone_number": "865-675-8000",
            "fax_number": "865-524-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOP",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3617",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q038444",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PRESCOTT",
            "middle_name": "LAUREN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.