Jacob Michael Stephens, APRN
Individual provider Active NPI Family Nurse Practitioner · Hartsville, TN
NPI 1700375136 · NPPES record last updated May 1, 2018
Key facts
- NPI
- 1700375136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 24127 (TN)
- Practice address
- 140 Macon Way
Hartsville, TN 37074 - Phone
- (615) 808-0400
- NPI assigned
- May 1, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Innovative Infusions LLC
Practice addresses (Care Compare)
318 Prosperity Dr
Knoxville, TN 37923-4710
Phone (865) 299-7525
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210514001241 | TN | Practitioner - Nurse Practitioner | 2567899727 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Infusions, LLC | Current |
Accepting new patients | |
| Innovative Infusions, LLC | Current |
Accepting new patients |
Locations
410 N Parrish Pl
Ste 3000
Hendersonville, TN 37075
Phone (615) 590-9503
318 Prosperity Dr
Knoxville, TN 37923
Phone (865) 299-7525
601 Grassmere Park
Ste 19
Nashville, TN 37211
Phone (629) 240-1231
3033 W President George Bush Hwy
Ste 100
Plano, TX 75075
Phone (877) 365-5566
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 24127 | TN | Yes |
Addresses
Primary practice location
140 Macon Way
Hartsville, TN 37074
Mailing address
113 Legends Ridge Dr
Lebanon, TN 37090-1565
Phone (615) 630-4457
Other providers in Hartsville, TN
- Floyd Reed Jr.
- Misty A Roberson
- Bienvenido T Samson
- Jennifer D. Spears
- State of Tennessee
- Tracy Lynne Summers
- Sumner Regional EMS LLC
- Trousdale County
- Trousdale Medical Center LLC
- Trousdale Medical Center LLC
All providers in Hartsville, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.