Individual provider Active NPI

Jule Ellen Michael, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1730471905
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
156859 Issued in TN
Practice address
2002 Brookside Dr Ste 102
Kingsport, TN 37660-4634
Phone
(423) 245-6000
Fax
(423) 245-4190
NPI assigned
May 6, 2011
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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 0024169320 VA
Family Nurse Practitioner 363LF0000X 156859 TN Primary

Addresses

Primary practice location

2002 Brookside Dr Ste 102
Kingsport, TN 37660-4634

Mailing address

2002 Brookside Dr
Ste 102
Kingsport, TN 37660-4634
Phone (423) 245-6000

Other practice location 1

119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615
Phone (423) 282-1480

Other identifiers 1

IdentifierTypeStateIssuer
15659OtherTNAPN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120131000563 TN Practitioner - Nurse Practitioner 7719165927
I20120426000124 VA Practitioner - Nurse Practitioner 7719165927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
156859TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Tennessee, P.C. Family Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jmichael12095@direct.acumenmd.com

Organizations & group practices 2

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": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1730471905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 BROOKSIDE DR",
            "address_2": "STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604634",
            "telephone_number": "423-245-6000",
            "fax_number": "423-245-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 BROOKSIDE DR STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604634",
            "telephone_number": "423-245-6000",
            "fax_number": "423-245-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Boone Ridge Dr",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37615",
            "country_code": "US",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "JULE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169320",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "156859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN",
            "identifier": "15659",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.