Jennifer Marie Harris, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

35023 Issued in TN

Practice address

525 N State of Franklin Rd
Johnson City, TN 37604-8213

Phone

(423) 302-3480

NPI assigned

Nov 2, 2023

Last updated

Nov 2, 2023By the provider in NPPES

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

Other names 1

• Jennifer Marie Bales Former name

Medicare fee-for-service enrollment

Enrolled in TN, IA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SBH-KingsportGroup PAC ID 8325399256, 10 clinicians

SBH-Davenport LLCGroup PAC ID 1759702756, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SBH-Kingsport

  dba Creekside Behavioral Health

  • Psychiatric Hospital
  • Kingsport, TN
  • NPI 1174038749
  Medicare reassignment Care Compare group NPD
• SBH-Davenport, LLC

  dba Eagle View Behavioral Health

  • Adult Mental Health Clinic/Center
  • Bettendorf, IA
  • NPI 1023817475
  Medicare reassignment Care Compare group NPD
• Medpsych Inc. PC

  • Specialist
  • Kingsport, TN
  • NPI 1962828137

  IA

  Medicare reassignment NPD
• SBH-Kingsport

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1801682299
  NPD
• SBH-Davenport, LLC

  dba Eagle View Behavioral Health

  • Psychiatric Hospital
  • Bettendorf, IA
  • NPI 1831720556
  NPD

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1912770850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048213",
            "telephone_number": "423-302-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048213",
            "telephone_number": "423-302-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "35023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BALES",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marc Dominic Harrington, MA, LPC
• Abbie Sarah Harris, FNP
• Arthur S Harris, MD
• Bailey Harris
• Brittany Amber Harris, RN, CBS
• Lacey A Harris
• Maggie Harris
• Steven A Harris, LPC, MHSP
• Anna Katherine Harrison
• Colleen Gloria Harrison, OTR

• Psychiatric/Mental Health Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.