Jordan Brooke Childress, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

29287 Issued in TN

Practice address

105 W Stone Dr Ste 1F
Kingsport, TN 37660-3365

Phone

(423) 230-2420

Fax

(423) 230-2422

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jordan Stivers Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.71 of 100Reported as apm

Quality

97.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

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.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667
  Medicare reassignment Care Compare group NPD
• State of Franklin Healthcare Associates PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1063459410

  Family Medicine

  Medicare reassignment NPD
• Well-Key Health, PLLC

  • Urgent Care Clinic/Center
  • Sevierville, TN
  • NPI 1114234382
  Medicare reassignment NPD
• State of Franklin Healthcare Associates PLLC

  • Clinical Medical Laboratory
  • Johnson City, TN
  • NPI 1841846136
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1679153720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 1F",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-230-2420",
            "fax_number": "423-230-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Med Tech Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042641",
            "country_code": "US",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "JORDAN",
        "middle_name": "BROOKE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173715",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "STIVERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carla Renee Cheek, FNP
• Celeste Marie Chervenka, LCSW
• Daniel John Chester
• Caroline Knauss Chestnut
• Cheng Eak Chew
• Candace Christian, NP
• Charles Jeffery Christian, D.PH.
• Christopher Christian
• Gloria Michelle Christy, BS
• Clayton Tomas Chroust, AGACNP, DNP

• Family Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.