Individual provider Active NPI

Jennifer Hamlin

  • Lactation Consultant (Non-RN)
  • Johnson City, TN
National Provider Identifier
1912606948
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
2760 Issued in TN
Practice address
2214 E Fairview Ave
Johnson City, TN 37601-2860
Phone
(423) 928-6464
Fax
(423) 282-2598
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X 2760 TN Primary
Occupational Therapist 225X00000X 2760 TN

Addresses

Primary practice location

2214 E Fairview Ave
Johnson City, TN 37601-2860

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

325 N State Of Franklin Rd
Johnson City, TN 37604-6056
Phone (423) 439-7320

Other practice location 2

1505 W Elk Ave Ste 1
Elizabethton, TN 37643-2848
Phone (423) 543-7919

Other identifiers 1

IdentifierTypeStateIssuer
Q082104MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212002414 TN Practitioner - Occupational Therapist in Private Practice 2062942592 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2760TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mini Miracles Pediatric Therapy, PLLC CurrentSince Oct 8, 2023 Accepting new patients
Fairview Therapy Occupational Therapist CurrentSince Mar 5, 2023 Accepting new patients
Medical Education Assistance Corporation CurrentSince Nov 24, 2024 Accepting new patients

Locations

1505 W Elk Ave
Ste 1
Elizabethton, TN 37643
Phone (423) 543-7919

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

2214 E Fairview Ave
Johnson City, TN 37601
Phone (423) 928-6464

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1912606948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 E FAIRVIEW AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012860",
            "telephone_number": "423-928-6464",
            "fax_number": "423-282-2598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046056",
            "country_code": "US",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 W Elk Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432848",
            "country_code": "US",
            "telephone_number": "423-543-7919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMLIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "TN",
            "license": "2760",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "2760",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q082104",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.