Individual provider Active NPI

Jessica L Titley, PA

  • Physician Assistant
  • Cookeville, TN
National Provider Identifier
1972057016
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
222 W 4TH St Ste 201
Cookeville, TN 38501-2413
Phone
(931) 783-4269
Fax
(931) 783-0401
NPI assigned
Aug 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

222 W 4TH St Ste 201
Cookeville, TN 38501-2413

Mailing address

140 W 7TH St
Cookeville, TN 38501-1726
Phone (931) 783-5582

Other identifiers 1

IdentifierTypeStateIssuer
Q059082MedicaidTN

Other names 1

  • Jessica Bezilla 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
I20200619002196 TN Practitioner - Physician Assistant 6608156138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Regional Medical Group IncGroup PAC ID 8325092638, 54 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 783-5857

100 W 4TH St
Suite 350
Cookeville, TN 38501-4225
Phone (931) 783-2753

Hospital & facility affiliations

  • Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score
40.99 of 100Reported as group
Quality
58.34
Promoting interoperability
0
Improvement activities
0
Cost
78.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4151TNMDOccupational Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: jessica.titley.1@10383.direct.athenahealth.com

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 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": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1972057016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-783-5582",
            "fax_number": "931-526-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 4TH ST STE 201",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012413",
            "telephone_number": "931-783-4269",
            "fax_number": "931-783-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITLEY",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q059082",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BEZILLA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.