Active NPI
Nanci Elizabeth Jackson, RN,MSN,CPNP
- Pediatric Nurse Practitioner
- Knoxville, TN
National Provider Identifier
1851498703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APN0000005941
- Practice address
- 140 Dameron Ave
Knoxville, TN 37917-6413 - Phone
- (865) 934-6100
- Fax
- (865) 342-0100
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APN0000005941 | TN | Primary |
Addresses
Primary practice location
140 Dameron Ave
Knoxville, TN 37917-6413
Mailing address
6350 W a J Hwy
Department 100
Talbott, TN 37877
Phone (800) 355-3565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000005941 | TN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291334400000",
"number": "1851498703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6350 W A J HWY",
"address_2": "DEPARTMENT 100",
"city": "TALBOTT",
"state": "TN",
"postal_code": "37877",
"telephone_number": "800-355-3565",
"fax_number": "423-714-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 DAMERON AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379176413",
"telephone_number": "865-934-6100",
"fax_number": "865-342-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "NANCI",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "RN,MSN,CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2010-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TN",
"license": "APN0000005941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.