Jackie C Noah, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1418 Issued in TN

Practice address

1907 W Morris Blvd
Suite G
Morristown, TN 37813-3860

Phone

(423) 318-0014

Fax

(423) 318-2595

NPI assigned

May 15, 2006

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 identifiers 1

Other names 1

• Mrs. Jackie C Justice Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Healthstar Physicians, P.C.

  • Family Medicine Physician
  • Morristown, TN
  • NPI 1184610248
  Medicare reassignment Care Compare group NPD
• Healthstar Physicians PC

  • Pain Medicine (Anesthesiology) Physician
  • Morristown, TN
  • NPI 1841187648
  NPD
• East Tennessee Primary Care Associates

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1134271745
  NPD (past)
• Dermatology Associates of Pikeville, PLLC

  • Dermatology Physician
  • Pikeville, KY
  • NPI 1811285117
  NPD (past)
• Ronald D Hall MD

  • Specialist
  • Pikeville, KY
  • NPI 1093825705
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1922059609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W MORRIS BLVD",
            "address_2": "SUITE G",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133860",
            "telephone_number": "423-318-0014",
            "fax_number": "423-318-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W MORRIS BLVD",
            "address_2": "SUITE G",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133860",
            "telephone_number": "423-318-0014",
            "fax_number": "423-318-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOAH",
        "first_name": "JACKIE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3664724",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie.justice.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1907 W Morris Blvd",
            "address_2": "Suite G",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378133860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "JUSTICE",
            "middle_name": "C",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie D Nichols, RN, APN
• Teresa Nichols, RN
• Connie Nickelson, MD
• Mary Beth Nicley, R.N.
• Joshua Nida, PHARMD
• Maranda Noble, PHARMD
• Angela Jeanette Noe, RN
• Olivia Carol Norton
• Karoline Lancaster Novilla, COTA
• Freddie Ngindu Nsapo, MAC/MPA

• Physician Assistant in Morristown, TN
• Providers in Morristown, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.
• 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.