Individual provider Active NPI

Heather L Verduzco, A.P.R.N.

  • Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1982062873
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20932 Issued in TN
Practice address
145 Innovation Dr
Jackson, TN 38305-3019
Phone
(731) 422-0213
Fax
(731) 422-0402
NPI assigned
Feb 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20932 TN Primary

Addresses

Primary practice location

145 Innovation Dr
Jackson, TN 38305-3019

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752

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
I20160226000782 TN Practitioner - Nurse Practitioner 9638474760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

101 Garrett Dr
Medina, TN 38355-9641
Phone (731) 422-0355

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

1893 S Highland Ave
Jackson, TN 38301-7799
Phone (731) 423-5585

22 2ND Ave
Huntingdon, TN 38344-3806
Phone (731) 422-0213

2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

3568 Chere Carol Rd
Humboldt, TN 38343-3639
Phone (731) 664-1375

4039 S Highland St
Milan, TN 38358-3483
Phone (731) 686-8995

619 Skyline Dr
Jackson, TN 38301-3903
Phone (731) 422-0213

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20932TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Oct 22, 2018 Accepting new patients
Jackson Clinic PA CurrentSince Oct 22, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 4, 2016 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 4, 2016 Accepting new patients

Locations

715 E Main St
Ste A
Henderson, TN 38340
Phone (731) 435-1488

1893 S Highland Ave
Jackson, TN 38301
Phone (731) 423-5585

700 W Forest Ave
Ste 300
Jackson, TN 38301
Phone (731) 422-0330

145 Innovation Dr
Jackson, TN 38305

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

Interoperability endpoints

  • Direct secure messaging: heatherverduzco@jcpa.allscriptsdirect.net

Organizations & group practices 4

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": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1982062873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-425-5752",
            "fax_number": "731-425-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 INNOVATION DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053019",
            "telephone_number": "731-422-0213",
            "fax_number": "731-422-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "20932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.