Individual provider Active NPI

Jacquelyn F Stinnes, NP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1972632362
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7697 Issued in TN
Practice address
3960 New Covington Pike
Memphis, TN 38128-2504
Phone
(901) 516-5741
Fax
(901) 516-1220
NPI assigned
Mar 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 118029 TN
Nurse Practitioner 363L00000X 7697 TN Primary

Addresses

Primary practice location

3960 New Covington Pike
Memphis, TN 38128-2504

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other identifiers 1

IdentifierTypeStateIssuer
3640121MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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

Enrollment IDStateProvider typePAC IDDetails
I20050504000365 TN Practitioner - Nurse Practitioner 9739129222 Reassigns benefits to 7 organizations
I20181107000924 MS Practitioner - Nurse Practitioner 9739129222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Inpatient Physicians LLCGroup PAC ID 1254241235, 123 clinicians

Practice addresses (Care Compare)

3960 New Covington Pike
Memphis, TN 38128-2504
Phone (901) 516-5741

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7697TNMDPhysical Therapist
118029TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carr PLLC CurrentSince Sep 30, 2017 Accepting new patients
Methodist North Emergency Physicians, PLLC CurrentSince Jan 10, 2024 Accepting new patients
Olive Branch Emergency Physicians LLC CurrentSince Jan 10, 2024 Accepting new patients
Methodist South Emergency Physicians, PLLC CurrentSince Jan 10, 2024 Accepting new patients
Germantown Emergency Physicians, PLLC CurrentSince Jan 10, 2024 Accepting new patients
Methodist University Emergency Physicians PLLC CurrentSince Jan 10, 2024 Accepting new patients
Methodist Inpatient Physicians LLC CurrentSince Nov 6, 2023 Accepting new patients
T M Carr MD PC Nurse Practitioner CurrentSince Feb 1, 2007 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1265 Union Ave
#1
Memphis, TN 38104
Phone (901) 516-8279

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: jstinnes27812@mlh.direct-ci.com

Organizations & group practices 8

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 3

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": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1972632362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 NEW COVINGTON PIKE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282504",
            "telephone_number": "901-516-5741",
            "fax_number": "901-516-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINNES",
        "first_name": "JACQUELYN",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "118029",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "7697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3640121",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.