Individual provider Active NPI

Jennifer Vallie Jeanne Minor, APRN, ACNP

  • Acute Care Nurse Practitioner
  • Hendersonville, TN
National Provider Identifier
1679163539
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
33409 Issued in TN
Practice address
355 New Shackle Island Rd
Hendersonville, TN 37075-2479
Phone
(615) 388-7720
NPI assigned
Jan 24, 2021
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 33409 TN Primary
Emergency Registered Nurse 163WE0003X 0000150949 TN

Addresses

Primary practice location

355 New Shackle Island Rd
Hendersonville, TN 37075-2479

Mailing address

1101 Minor Rd
Bethpage, TN 37022-9185
Phone (615) 388-7720

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
I20230321000840 TN Practitioner - Nurse Practitioner 5890169502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Anesthesiologists PCGroup PAC ID 4688571045, 142 clinicians

Practice addresses (Care Compare)

4230 Harding Pike
Suite 435
Nashville, TN 37205-4900
Phone (615) 385-3704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000150949TNMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Anesthesiologists PC Acute Care CurrentSince Jun 1, 2024 Accepting new patients

Locations

4230 Harding Pike
Ste 435
Nashville, TN 37205
Phone (615) 385-3704

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1611446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1679163539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MINOR RD",
            "city": "BETHPAGE",
            "state": "TN",
            "postal_code": "370229185",
            "telephone_number": "615-388-7720",
            "fax_number": "615-888-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NEW SHACKLE ISLAND RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752479",
            "telephone_number": "615-388-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JENNIFER",
        "middle_name": "VALLIE JEANNE",
        "name_prefix": "Mrs.",
        "credential": "APRN, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-24",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "33409",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TN",
            "license": "0000150949",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.