Individual provider Active NPI

Emily Jackson Gardner

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1891673463
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
39551 Issued in TN
Practice address
301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone
(423) 794-5520
NPI assigned
Aug 22, 2025
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 39551 TN Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641

Mailing address

820 Old Stage Rd
Gray, TN 37615-3845
Phone (423) 557-7960

Other names 1

  • Emily Brooke Jackson 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
I20251009003214 TN Practitioner - Nurse Practitioner 6800393380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
39551TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Sep 9, 2025 Accepting new patients

Locations

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239

301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520

310 N State of Franklin Rd
Ste 303
Johnson City, TN 37604
Phone (423) 926-8181

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

Interoperability endpoints

  • Direct secure messaging: emilygardner@sofha.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1891673463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 OLD STAGE RD",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153845",
            "telephone_number": "423-557-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 240",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042641",
            "telephone_number": "423-794-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EMILY",
        "middle_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "39551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "JACKSON",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.