Individual provider Active NPI

Abby Rebecca Carrick

  • Family Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1710840970
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
40411 Issued in TN
Practice address
1646 Russell Ave
Jefferson City, TN 37760-2204
Phone
(865) 635-9637
NPI assigned
Dec 4, 2025
Last updated
Dec 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 40411 TN Primary

Addresses

Primary practice location

1646 Russell Ave
Jefferson City, TN 37760-2204

Mailing address

147 Fairway Dr
Johnson City, TN 37615-2301
Phone (423) 863-3556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 50
Rogersville, TN 37857-0850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40411TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1710840970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 FAIRWAY DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376152301",
            "telephone_number": "423-863-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 RUSSELL AVE",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602204",
            "telephone_number": "865-635-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRICK",
        "first_name": "ABBY",
        "middle_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "40411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.