Individual provider Active NPI

Lori Kay Jenkins, PMHNP-BC, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1740284728
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
06197 Issued in TN
Practice address
137 Terrace PL
Jackson, TN 38301-4836
Phone
(731) 435-3060
Fax
(833) 941-2599
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 06197 TN Primary

Addresses

Primary practice location

137 Terrace PL
Jackson, TN 38301-4836

Mailing address

137 Terrace PL
Jackson, TN 38301-4836
Phone (731) 435-3060

Other identifiers 1

IdentifierTypeStateIssuer
1507251MedicaidTN

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
I20040724000413 TN Practitioner - Nurse Practitioner 9234119678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

137 Terrace PL
Jackson, TN 38301-4836
Phone (731) 435-3060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06197TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mind and Body Healthcare CurrentSince Nov 20, 2021 Accepting new patients
WT University Medical Associates Inc Current Accepting new patients
Integrated Health Transitions, PLLC PastSince Feb 1, 2018 Accepting new patients
Renuven Health Partners of Georgia PC Past Accepting new patients
Hardeman County Community Health Center Past Accepting new patients

Locations

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

Interoperability endpoints

  • Direct secure messaging: mindandbodyhealthcare.lorijenkins@158849.advancedmd-direct.com
  • Direct secure messaging: lori.jenkins.1@23763.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23763/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1740284728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 TERRACE PL",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014836",
            "telephone_number": "731-435-3060",
            "fax_number": "833-941-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 TERRACE PL",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014836",
            "telephone_number": "731-435-3060",
            "fax_number": "833-941-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LORI",
        "middle_name": "KAY",
        "credential": "PMHNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2021-07-16",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "06197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507251",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.