Individual provider Active NPI

Jana M. Stovall, NP

  • Family Nurse Practitioner
  • Lynchburg, TN
National Provider Identifier
1811317068
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18685 Issued in TN
Practice address
491 Majors Blvd
Lynchburg, TN 37352-8344
Phone
(931) 759-4727
Fax
(931) 759-4729
NPI assigned
Apr 25, 2014
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 18685 TN
Family Nurse Practitioner 363LF0000X 18685 TN Primary

Addresses

Primary practice location

491 Majors Blvd
Lynchburg, TN 37352-8344

Mailing address

491 Majors Blvd
Lynchburg, TN 37352-8344
Phone (931) 759-4727

Other practice location 1

1940 N Jackson St Ste 220
Tullahoma, TN 37388-8256
Phone (931) 455-4616

Other names 1

  • Jana M Haidak Other name

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
I20141118002027 TN Practitioner - Nurse Practitioner 0042432544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Southern Tennessee LLCGroup PAC ID 5991765943, 54 clinicians

Practice addresses (Care Compare)

491 Majors Blvd
Lynchburg, TN 37352-8344
Phone (931) 759-4727

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince Apr 1, 2025 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Apr 1, 2025 Accepting new patients
Proxima Centauri, PLLC CurrentSince Aug 17, 2023 Accepting new patients
Amg-Southern Tennessee LLC Past Accepting new patients
Amg -Southern Tennessee LLC Past Accepting new patients
Banyan Healthcare & Wellness Center, LLC PastSince Apr 1, 2021 Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

491 Majors Blvd
Lynchburg, TN 37352
Phone (931) 759-4727

1600 McArthur St
Manchester, TN 37355
Phone (931) 723-7950

1940 N Jackson St
Ste 220
Tullahoma, TN 37388
Phone (931) 455-4616

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Interoperability endpoints

  • Direct secure messaging: jana.stovall.1@19363.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1811317068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 MAJORS BLVD",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373528344",
            "telephone_number": "931-759-4727",
            "fax_number": "931-759-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 MAJORS BLVD",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373528344",
            "telephone_number": "931-759-4727",
            "fax_number": "931-759-4729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 N Jackson St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Tullahoma",
            "state": "TN",
            "postal_code": "373888256",
            "country_code": "US",
            "telephone_number": "931-455-4616",
            "fax_number": "931-455-2362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "JANA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "18685",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANA",
            "last_name": "HAIDAK",
            "middle_name": "M",
            "credential": "NP FAMILY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lynchburg, TN

Sources for this page

Verify at the official NPI Registry.