Tina Connell, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

31501 Issued in TN

Practice address

620 Skyline Dr
Jackson, TN 38301-3923

Phone

(731) 541-5000

Fax

(731) 660-8739

NPI assigned

May 5, 2022

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• West Tennessee Healthcare Hospitalists Inc

  • Hospitalist Physician
  • Jackson, TN
  • NPI 1720635188
  Medicare reassignment NPD

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1891430617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BANCORP SOUTH PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057582",
            "telephone_number": "731-512-1264",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "TINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Behavioral Health
• Comprehensive Industrial Solutions
• Amanda Comstock, MS
• Leigh Ann Conder
• Devin Conley, RPH
• Dionna Latrice Conner, RBT
• Shavetta D Conner, MD
• Anna M Cook, PMHNP, CNS, MSN
• James Brian Cook, M.S.
• Kathryn M Cook, LPC

• Family Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.