Individual provider Active NPI

Kristie Jackson, APN

  • Acute Care Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1891765970
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
10926 Issued in TN
Practice address
4230 Harding Pike
Suite 330
Nashville, TN 37205
Phone
(615) 269-4545
Fax
(615) 565-6789
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0000010926 TN
Acute Care Nurse Practitioner 363LA2100X 2004003624 TN
Acute Care Nurse Practitioner 363LA2100X 10926 TN Primary

Addresses

Primary practice location

4230 Harding Pike
Suite 330
Nashville, TN 37205

Mailing address

300 20TH Ave N Ste 403
Nashville, TN 37203-5180
Phone (615) 284-7260

Other identifiers 3

IdentifierTypeStateIssuer
1519858MedicaidTN
6011957OtherTNBCBS
P01167551OtherTNRR MEDICARE

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
I20120503000357 TN Practitioner - Nurse Practitioner 0042263717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

2121 N Locust Ave
Suite 6
Lawrenceburg, TN 38464-4454
Phone (615) 269-4545

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

4230 Harding Pike
Nashville, TN 37205-2018

Hospital & facility affiliations

  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10926TNMDGeneral Practice Dentistry
APN0000010926TNMDNurse Practitioner
2004003624TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince May 13, 2014 Accepting new patients
Saint Thomas Medical Partners CurrentSince May 13, 2014 Accepting new patients

Locations

745 S Church St
Ste A130
Murfreesboro, TN 37130
Phone (615) 895-6900

745 S Church St
Ste 501
Murfreesboro, TN 37130
Phone (615) 295-2411

4230 Harding Pike
Ste 330
Nashville, TN 37205
Phone (800) 345-5016

300 20th Ave N
Fl 9
Nashville, TN 37203

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

Interoperability endpoints

  • Direct secure messaging: kristie.jackson.1@7654.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1891765970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 403",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035180",
            "telephone_number": "615-284-7260",
            "fax_number": "615-284-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE",
            "address_2": "SUITE 330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37205",
            "telephone_number": "615-269-4545",
            "fax_number": "615-565-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000010926",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "2004003624",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "10926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519858",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6011957",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01167551",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.