Jordan Roundtree, APRN, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

34146 Issued in TN

Practice address

142 Public SQ Ste E-104
Lebanon, TN 37087-2871

Phone

(931) 288-4619

Fax

(931) 208-4063

NPI assigned

Jun 2, 2023

Sex

Male

Sole proprietor

No

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Roundtree Mental Health Group PLLCGroup PAC ID 8628415817, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Roundtree Mental Health Group PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, TN
  • NPI 1376308635
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1871286989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 PUBLIC SQ STE E-104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872871",
            "telephone_number": "931-288-4619",
            "fax_number": "931-208-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 PUBLIC SQ STE E-104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872871",
            "telephone_number": "931-288-4619",
            "fax_number": "931-208-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNDTREE",
        "first_name": "JORDAN",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "34146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Roney
• Billy Rogers Ross Jr., LPC
• Michelle Ross, RD
• Roundtree Mental Health Group PLLC
• Alan W Roundtree, M.D.
• Tiffani Briana Roundtree
• Alivia Rowe, RBT
• Rox Dental Partners, PLLC
• Sarah Michelle Rudder, PA-C
• Russell K Kirk, DDS, PC

• Psychiatric/Mental Health Nurse Practitioner in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.