Individual provider Active NPI

Jennifer Kendra McDaniel, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sevierville, TN
National Provider Identifier
1780926923
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
33515 Issued in TN
Practice address
1105 Oak Cluster Dr
Sevierville, TN 37862-6079
Phone
(865) 429-0557
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 187047 TN
Community Health Registered Nurse 163WC1500X 187047 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 33515 TN Primary

Addresses

Primary practice location

1105 Oak Cluster Dr
Sevierville, TN 37862-6079

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

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
I20230726002142 TN Practitioner - Nurse Practitioner 4082075890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Helen Ross McNabb CenterGroup PAC ID 1658278809, 40 clinicians

Practice addresses (Care Compare)

1105 Oak Cluster Dr
Sevierville, TN 37862-6079
Phone (865) 429-0557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
187047TNMDCommunity Health Registered Nurse
33515TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Apr 24, 2023 Accepting new patients

Locations

1515 Saint Mary St
Knoxville, TN 37917
Phone (865) 213-1550

5310 Ball Camp Pike
Knoxville, TN 37921
Phone (865) 262-8208

5645 Merchants Center Blvd
Knoxville, TN 37912
Phone (865) 257-9982

201 W Springdale Ave
Knoxville, TN 37917
Phone (865) 329-9173

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 329-9124

990 W Highway 25 70
Newport, TN 37821
Phone (423) 248-5146

1105 Oak Cluster Dr
Sevierville, TN 37862
Phone (865) 366-4070

Organizations & group practices 1

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1780926923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 OAK CLUSTER DR",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626079",
            "telephone_number": "865-429-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JENNIFER",
        "middle_name": "KENDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "187047",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "187047",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "33515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.