Individual provider Active NPI

Jaime Lee McClellan, APRN

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1770113136
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27139 Issued in TN
Practice address
2012 Chilhowee Medical Park
Maryville, TN 37804-5285
Phone
(865) 205-6449
NPI assigned
Jan 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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 27139 TN Primary

Addresses

Primary practice location

2012 Chilhowee Medical Park
Maryville, TN 37804-5285

Mailing address

1787 Veterans Blvd
Sevierville, TN 37862-6945
Phone (423) 470-3416

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
I20201223001826 TN Practitioner - Nurse Practitioner 1254743891 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Well-Key Health, PLLC CurrentSince Oct 25, 2020 Accepting new patients
Chuc, LLC Family PastSince Jan 1, 2021 Accepting new patients

Locations

1787 Veterans Blvd
Ste 101
Sevierville, TN 37862
Phone (865) 428-2773

Organizations & group practices 3

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1770113136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 VETERANS BLVD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626945",
            "telephone_number": "423-470-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-205-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "JAIME",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.