Individual provider Active NPI

Rhiannon Michelle Andresen, FNP-C

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1831750843
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25950 Issued in TN
Practice address
1022 Greystone SQ
Jackson, TN 38305-3580
Phone
(731) 300-2001
Fax
(731) 240-8065
NPI assigned
Jun 21, 2019
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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 25950 TN Primary

Addresses

Primary practice location

1022 Greystone SQ
Jackson, TN 38305-3580

Mailing address

1022 Greystone SQ
Jackson, TN 38305-3580
Phone (731) 300-2001

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
I20200928002684 TN Practitioner - Nurse Practitioner 0648699439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Grace Family Practice Clinic, PCGroup PAC ID 9537426044, 3 clinicians

Practice addresses (Care Compare)

1716 Parr Ave
Suite D
Dyersburg, TN 38024-2074
Phone (731) 288-0911

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25950TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Family Practice Clinic, P.C. Family CurrentSince Sep 1, 2023 Accepting new patients
Family Medical Clinic of Trezevant CurrentSince Nov 21, 2021 Accepting new patients
Family Medical Clinic of Trezevant CurrentSince Jun 1, 2020 Accepting new patients

Locations

1716 Parr Ave
Ste D
Dyersburg, TN 38024
Phone (731) 288-0911

1937 Cook St
Dyersburg, TN 38024
Phone (731) 287-2307

1022 Greystone Sq
Jackson, TN 38305
Phone (731) 300-2001

45 Hurt St
Trezevant, TN 38258
Phone (731) 207-0323

Interoperability endpoints

  • Direct secure messaging: rhiannon.andressen@gfpc.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1831750843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053580",
            "telephone_number": "731-300-2001",
            "fax_number": "731-240-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053580",
            "telephone_number": "731-300-2001",
            "fax_number": "731-240-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRESEN",
        "first_name": "RHIANNON",
        "middle_name": "MICHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.