Individual provider Active NPI

Jena Daniel

  • Acute Care Nurse Practitioner
  • Leoma, TN
National Provider Identifier
1689120644
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
20116 Issued in TN
Practice address
37 Day Rd
Leoma, TN 38468-5502
Phone
(256) 710-5299
NPI assigned
Aug 30, 2016
Last updated
Aug 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 20116 TN Primary

Addresses

Primary practice location

37 Day Rd
Leoma, TN 38468-5502

Mailing address

37 Day Rd
Leoma, TN 38468-5502
Phone (256) 710-5299

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
I20161006002533 TN Practitioner - Nurse Practitioner 8628366655 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, shared by 15 NPIs, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

129 N Locust Ave
Lawrenceburg, TN 38464-3757
Phone (931) 762-7232

1321 Huntsville Hwy
Fayetteville, TN 37334-3603
Phone (855) 632-3278

1414 W College St
Pulaski, TN 38478-5202
Phone (931) 363-3004

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

600 S James M Campbell Blvd
Columbia, TN 38401-4334
Phone (931) 398-1757

811 N Main St
Mt Pleasant, TN 38474-1017
Phone (931) 379-3229

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 22, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 22, 2021 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

1414 W College St
Pulaski, TN 38478
Phone (931) 363-3004

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, 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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1689120644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 DAY RD",
            "city": "LEOMA",
            "state": "TN",
            "postal_code": "384685502",
            "telephone_number": "256-710-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 DAY RD",
            "city": "LEOMA",
            "state": "TN",
            "postal_code": "384685502",
            "telephone_number": "256-710-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "JENA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "20116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leoma, TN

Sources for this page

Verify at the official NPI Registry.