Jaime Phillips, PMHNP, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

28055 Issued in TN

Practice address

482 Interstate Dr
Manchester, TN 37355-3485

Phone

(931) 444-1000

Fax

(931) 728-1229

NPI assigned

Jun 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jaime Stanford 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

East Tennessee State University Quillen College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee Medical Group LLCGroup PAC ID 1850208794, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unity Medical Center Hospital, Manchester, TN, CCN 440007

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaime.phillips@mcrhc.eclinicaldirectplus.com

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.

• Coffee Medical Group LLC

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  Medicare reassignment Care Compare group NPD
• Coffee Medical Group LLC

  • Rural Health Clinic/Center
  • Manchester, TN
  • NPI 1043537046
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Coffee Medical Group LLC

  • Rural Acute Care Hospital
  • Manchester, TN
  • NPI 1013969179
  Care Compare affiliation

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1679190532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 MIDDLE TN BLVD APT F13",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371300938",
            "telephone_number": "615-785-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 INTERSTATE DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553485",
            "telephone_number": "931-444-1000",
            "fax_number": "931-728-1229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 McMinnville Hwy",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "TN",
            "postal_code": "373553179",
            "country_code": "US",
            "telephone_number": "931-444-1000",
            "fax_number": "931-728-1229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JAIME",
        "credential": "PMHNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "28055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "STANFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith Anderson Patterson
• Paul E. Honeycutt, DDS
• Misty Niroca Paul
• Brian Walter Petersen, D.O.
• Denise Pettinger, FNP
• Kathryn A Phillips, MSNRNCS
• Mariah Shaneil Phillips, RN
• Alysa Posey, RN
• Regina Maria Poston, RN
• Jessica Pratt, FNP

• Psychiatric/Mental Health Nurse Practitioner in Manchester, TN
• Providers in Manchester, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.