Individual provider Active NPI

Judith A. Rice, FNP

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Johnson City, TN
National Provider Identifier
1770512642
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
APN6995 Issued in TN
Practice address
202 W. Fairview Aveneu
Johnson City, TN 37604
Phone
(423) 434-6478
Fax
(423) 434-0666
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 APN006995 TN
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X APN6995 TN Primary

Addresses

Primary practice location

202 W. Fairview Aveneu
Johnson City, TN 37604

Mailing address

365 Stout Drive Box70403
Johnson City, TN 37614-1703
Phone (423) 439-4515

Other identifiers 4

IdentifierTypeStateIssuer
1527509MedicaidTN
100040291OtherTNPHP
JTN0178OtherTNJOHN DEERE
4284574OtherTNBCBST

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
I20120103000708 TN Practitioner - Nurse Practitioner 0143496745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

202 W Fairview Ave
Johnson City, TN 37604-5611
Phone (423) 439-7371

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN006995TNMDFamily Nurse Practitioner
APN6995TNMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee State University CurrentSince Nov 13, 2011 Accepting new patients
East Tennessee State University CurrentSince Nov 13, 2011 Accepting new patients
East Tennessee State University Past Accepting new patients

Locations

400 Jl Seehorn Jr Rd
Johnson City, TN 37614
Phone (423) 320-3976

2151 Century Ln
Johnson City, TN 37604
Phone (423) 439-4071

202 W Fairview Ave
Johnson City, TN 37604
Phone (423) 439-7371

1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100

2700 Main St
Sneedville, TN 37869
Phone (423) 733-2819

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1770512642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 STOUT DRIVE BOX70403",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141703",
            "telephone_number": "423-439-4515",
            "fax_number": "423-439-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W. FAIRVIEW AVENEU",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-434-6478",
            "fax_number": "423-434-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "JUDITH",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN006995",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN6995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527509",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "100040291",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "JTN0178",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4284574",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.