Kenneth S Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17382 Issued in TN

Practice address

123 Maple St
Bruceton, TN 38317-1819

Phone

(731) 586-4800

Fax

(731) 352-4459

NPI assigned

Feb 25, 2013

Last updated

Oct 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McKenzie Medical Center PCGroup PAC ID 2365427853, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Extendicare Home Health of West TN Home health agency, Dyersburg, TN, CCN 447284
• Volunteer Home Care Home health agency, Humboldt, TN, CCN 447557
• Amedisys Home Health Care Home health agency, Jackson, TN, CCN 447278
• Baptist Memorial Home Care Home health agency, Huntingdon, TN, CCN 447444
• Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016
• West Tennessee Healthcare Camden Hospital Hospital, Camden, TN, CCN 441316
• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• West Tennessee Healthcare Henry County Hospital Hospital, Paris, TN, CCN 440132

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1568/brand/1/csg/21/fhir/r4

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.

• McKenzie Medical Center PC

  dba Hometown Health Clinic

  • Clinic/Center
  • McKenzie, TN
  • NPI 1700534229
  Medicare reassignment Care Compare group NPD
• McKenzie Medical Center PC

  dba Hometown Health Clinic

  • Rural Health Clinic/Center
  • McKenzie, TN
  • NPI 1023611241
  NPD
• McKenzie Medical Center PC

  dba Hometown Health Clinic

  • Rural Health Clinic/Center
  • McKenzie, TN
  • NPI 1477516953

  Family

  NPD
• McKenzie Medical Center PC

  dba Hometown Health Clinic

  • Rural Health Clinic/Center
  • Greenfield, TN
  • NPI 1932084274
  NPD
• McKenzie Clinic Corp

  • Family Medicine Physician
  • McKenzie, TN
  • NPI 1174526701
  NPD (past)
• McKenzie Medical Center

  • Sleep Disorder Diagnostic Clinic/Center
  • McKenzie, TN
  • NPI 1225267479
  NPD (past)
• McKenzie Medical Center

  • Urgent Care Clinic/Center
  • McKenzie, TN
  • NPI 1841696192

  Family

  NPD (past)
• McKenzie Medical Center, PC

  dba Hometown Health Clinic

  • Rural Health Clinic/Center
  • Gleason, TN
  • NPI 1225083991

  Family

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital-Huntingdon

  dba Baptist Memorial Hospital - Carroll County

  • General Acute Care Hospital
  • Huntingdon, TN
  • NPI 1710941356
  Care Compare affiliation
• Camden General Hospital, Inc.

  dba West Tennessee Healthcare Camden Hospital

  • Critical Access Hospital
  • Camden, TN
  • NPI 1659347920
  Care Compare affiliation
• HHC, LLC

  dba Amedisys Home Health Care

  • Home Health Agency
  • Jackson, TN
  • NPI 1851349559
  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• LHCG Xciv, LLC

  dba Baptist Memorial Home Care & Hospice

  • Home Health Agency
  • Huntingdon, TN
  • NPI 1568997252
  Care Compare affiliation
• Lifeline of West Tennessee, LLC

  dba Extendicare Home Health of West Tennessee

  • Home Health Agency
  • Dyersburg, TN
  • NPI 1821288572
  Care Compare affiliation
• Volunteer Home Care, Inc.

  • Home Health Agency
  • Humboldt, TN
  • NPI 1659320190
  Care Compare affiliation
• West Tennessee Healthcare Henry County

  dba West Tennessee Healthcare County Hospital

  • General Acute Care Hospital
  • Paris, TN
  • NPI 1497750244
  Care Compare affiliation

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1811237001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MAPLE ST",
            "city": "BRUCETON",
            "state": "TN",
            "postal_code": "383171819",
            "telephone_number": "731-586-4800",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30810 Broad St",
            "address_purpose": "LOCATION",
            "city": "Bruceton",
            "state": "TN",
            "postal_code": "383172028",
            "country_code": "US",
            "telephone_number": "731-586-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205A Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382011649",
            "country_code": "US",
            "telephone_number": "731-352-7907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205A Court Sq",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383443710",
            "country_code": "US",
            "telephone_number": "731-535-5765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1894 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382012206",
            "country_code": "US",
            "telephone_number": "731-207-6496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Highway 641 N",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "TN",
            "postal_code": "383203012",
            "country_code": "US",
            "telephone_number": "731-213-2344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KENNETH",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-25",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q001235",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3380640",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "10350I2435",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruby Hunt
• Sheila S Hunter, DPH
• Terine Israel, RBT, BA, MPM
• Brooklyn Fayth Ivy
• Hali Jackson
• Owen Jensen
• Amber Johnson
• Ashlei Johnson
• Tylan Johnson
• Amber Jordan

• Family Nurse Practitioner in Bruceton, TN
• Providers in Bruceton, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.