JTP Enterprises, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7811 Issued in TN

Legal business name

JTP ENTERPRISES, LLC

Practice address

287 Turntable Rd.
Sparta, TN 38583

Phone

(931) 738-2000

Fax

(888) 337-7080

NPI assigned

Aug 31, 2012

Organization subpart

No

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

Authorized official

Name

Jerry W Pernell, CFNP

Title

Ceo

Phone

(931) 707-7117

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• The Family Care Clinic of Sparta Doing business as

Locations

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1972852341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 TURNTABLE RD.",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "38583",
            "telephone_number": "931-738-2000",
            "fax_number": "888-337-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 TURNTABLE RD.",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "38583",
            "telephone_number": "931-738-2000",
            "fax_number": "888-337-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JTP ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "PERNELL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-707-7117",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "7811",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TN",
            "license": "7811",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448921",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548460447",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Care Clinic of Sparta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Nicole Jones
• Jessica Lynne Jones, COTA/L
• Pamela Jones, MS, LMFT
• Daphne Jeanette Jordan
• Joseph Marc Ross D.D.S., P.L.L.C.
• Stylianos A Kakoullis, MD
• Zachary Ethan Keel, PHARMD
• Abhay G Kemkar, MD
• Mina Magdy Fikry Khalil
• Molly Ann Kimmell, RN

• Family Medicine Physician in Sparta, TN
• Providers in Sparta, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.