Kelly Amanda Jackson, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APN0000023786 Issued in TN

Practice address

1700 Medical Center Pkwy
Murfreesboro, TN 37129-2245

Phone

(615) 396-4100

NPI assigned

May 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Neurology Center PLLCGroup PAC ID 0648442269, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.jackson.1@30188.direct.athenahealth.com

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.

• Comprehensive Neurology Center, PLLC

  • Pain Medicine Physician
  • Murfreesboro, TN
  • NPI 1588944532
  Medicare reassignment Care Compare group NPD
• Advanced Diagnostic Imaging, PC

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464
  Medicare reassignment NPD
• Advanced Diagnostic Imaging PC

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD
• Comprehensive Neurology Center, PLLC

  • Pain Medicine Physician
  • Mt Juliet, TN
  • NPI 1407302169
  NPD

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1841780178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL CENTER PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292245",
            "telephone_number": "615-396-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL CENTER PKWY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292245",
            "telephone_number": "615-396-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KELLY",
        "middle_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000023786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Michael Jackson, M.D.
• Christina Jackson, LPC-MHSP
• Elizabeth Galland Jackson, M.D.
• Jeffrey Brett Jackson, PHARMD,BSPHARMSCI,BS
• Joseph Jackson, DC
• Lacey H Jackson, LCSW
• Madison Jackson, RBT
• Marilyn Moran Jackson, DC
• Morgan F Jackson, MD
• Myrvienne Jackson, FNP

• Acute Care Nurse Practitioner in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; 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.