Individual provider Active NPI

Amy R Jordan, FNP

  • Family Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1699516500
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024189186 Issued in VA
Practice address
1 Medical Park Blvd Ste 250W
Bristol, TN 37620-7431
Phone
(423) 844-6620
Fax
(423) 844-6626
NPI assigned
Jun 4, 2024
Last updated
May 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35017 TN
Family Nurse Practitioner 363LF0000X 0024189186 VA Primary

Addresses

Primary practice location

1 Medical Park Blvd Ste 250W
Bristol, TN 37620-7431

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

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
I20260218004171 TN Practitioner - Nurse Practitioner 1153862735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1021 W Oakland Ave
Suite 310
Johnson City, TN 37604-2192

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35017TNMDFamily Nurse Practitioner
0024189186VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WPS Providers Inc CurrentSince Apr 1, 2026 Accepting new patients
Wellmont Cardiology Services Family CurrentSince Jun 1, 2024 Accepting new patients
Wellmont Health System Current Accepting new patients
Wellmont Physician Services Inc Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1 Medical Park Blvd
Ste 250W
Bristol, TN 37620
Phone (423) 844-6407

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

16000 Johnston Memorial Dr
Ste 212A
Abingdon, VA 24211
Phone (276) 258-1000

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

671 Highway 58 E
Norton, VA 24273
Phone (276) 679-5874

127 Health Care Dr
Ste 3
Pennington Gap, VA 24277
Phone (276) 299-5000

Interoperability endpoints

  • Direct secure messaging: ajordan81070@balladhealth.medalliesdirect.net

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.

Hospital & facility affiliations 6

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1699516500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 250W",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207431",
            "telephone_number": "423-844-6620",
            "fax_number": "423-844-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35017",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024189186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.