NPIMap

Individual provider Active NPI

Jennifer Rene Jennings, FNP-BC

  • Family Nurse Practitioner
  • McKenzie, TN
National Provider Identifier
1891249645
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21548 Issued in TN
Practice address
205 Hospital Drive
Suite a
McKenzie, TN 38201
Phone
(731) 352-7907
Fax
(731) 352-4459
NPI assigned
Aug 10, 2016
Last updated
Jan 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 21548 TN Primary

Addresses

Primary practice location

205 Hospital Drive
Suite a
McKenzie, TN 38201

Mailing address

205 Hospital Drive
Suite a
McKenzie, TN 38201
Phone (731) 352-7907

Other identifiers 2

IdentifierTypeStateIssuer
3380640OtherTNGROUP MEDICAID
3380649OtherTNMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170123001623 TN Practitioner - Nurse Practitioner 3274815519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Terrell Clinic, LLCGroup PAC ID 6204912645, 3 clinicians

Practice addresses (Care Compare)

701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5886
Phone (731) 885-9687

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21548TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Family Medicine, LLC CurrentSince Apr 15, 2019 Accepting new patients
Terrell Clinic LLC Family CurrentSince Dec 12, 2023 Accepting new patients
West Tennessee Orthopedics and Sports Medicine,P.C. PastSince Dec 12, 2023 Accepting new patients
McKenzie Medical Center, PC Family Past Accepting new patients
McKenzie Medical Center Past Accepting new patients
McKenzie Medical Center Family Past Accepting new patients

Locations

189 Mount Pelia Rd
Martin, TN 38237
Phone (731) 281-4760

79 Highway 51 S
Ripley, TN 38063
Phone (731) 635-8189

701 E Reelfoot Ave
Ste 100
Union City, TN 38261
Phone (731) 885-2235

Organizations & group practices 6

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 3

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1891249645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DRIVE",
            "address_2": "SUITE A",
            "city": "MCKENZIE",
            "state": "TN",
            "postal_code": "38201",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DRIVE",
            "address_2": "SUITE A",
            "city": "MCKENZIE",
            "state": "TN",
            "postal_code": "38201",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JENNIFER",
        "middle_name": "RENE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "3380640",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3380649",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McKenzie, TN

Sources for this page

Verify at the official NPI Registry.