Individual provider Active NPI

Jennifer Leigh White, CRNP

  • Pediatric Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1851536015
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
13667 Issued in TN
Practice address
1718 Saint Mary St Ste a
Knoxville, TN 37917-4518
Phone
(865) 540-4288
Fax
(865) 637-6983
NPI assigned
Dec 2, 2008
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 13667 TN Primary
Pediatrics Physician 208000000X APN0000013667 TN

Addresses

Primary practice location

1718 Saint Mary St Ste a
Knoxville, TN 37917-4518

Mailing address

1718 Saint Mary St Ste a
Knoxville, TN 37917-4518
Phone (865) 540-4288

Other practice location 1

11146 Parkside Dr
Knoxville, TN 37934-1960
Phone (865) 364-1067

Other names 1

  • Jennifer Leig Damewood Former 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
I20221204000035 TN Practitioner - Nurse Practitioner 3678942224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000013667TNMDPediatrics Physician
13667TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care for Children, PLLC Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Children's Urgent Care, LLC Pediatrics PastSince Nov 30, 2020 Accepting new patients
East Tennessee Neonatal Associates, P.C. Past Accepting new patients

Locations

500 Cahaba Park Cir
Ste 100
Birmingham, AL 35242
Phone (205) 848-2273

5215 Highway 153
Ste 105
Hixson, TN 37343
Phone (423) 664-1151

11146 Parkside Dr
Knoxville, TN 37934
Phone (865) 246-2830

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.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1851536015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 SAINT MARY ST STE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174518",
            "telephone_number": "865-540-4288",
            "fax_number": "865-637-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SAINT MARY ST STE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174518",
            "telephone_number": "865-540-4288",
            "fax_number": "865-637-6983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11146 Parkside Dr",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379341960",
            "country_code": "US",
            "telephone_number": "865-364-1067",
            "fax_number": "865-364-1068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "13667",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "APN0000013667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DAMEWOOD",
            "middle_name": "LEIG",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.