Amanda G Jack

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6201 Issued in TN

Practice address

77 Belinda Pkwy
Mt Juliet, TN 37122-4390

Phone

(615) 391-4394

NPI assigned

Jul 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urology Associates PCGroup PAC ID 2961392931, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandajack@uroassoc.allscriptsdirect.net

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.

• Urology Associates PC

  • Urology Physician
  • Nashville, TN
  • NPI 1043297542
  Medicare reassignment Care Compare group
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  Physician Assistant, TN

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Hermitage, TN
  • NPI 1982650024
  Care Compare affiliation

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1982432316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BELINDA PKWY",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371224390",
            "telephone_number": "615-573-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BELINDA PKWY",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224390",
            "telephone_number": "615-391-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "AMANDA",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-25",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intune Chiropractic Clinic, Inc.
• Isd Renal, Inc
• Remonda Ishak
• Farah Adel Ismail, PHARMD
• Chidinma Iwueke
• Kailee Jackola
• Jackson Dental Alliance, PLLC
• Amber Jackson
• Jamill Jackson
• Kristin Rashawn Jackson, RBT

• Physician Assistant in Mt Juliet, TN
• Providers in Mt Juliet, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.