Jennifer L Mabry, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN6851 Issued in TN

Practice address

228 W 4TH St
Ste 200
Cookeville, TN 38501-2488

Phone

(931) 372-0405

Fax

(931) 372-0463

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865

  TN

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1982605382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN96949",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN6851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3906449",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Luther, SLP-CCC
• Luxottica Retail North America Inc
• Annette J Lynch, LPC-MHSP
• Karen Yvonne Lynn, FAMILY NURSE PRACTIT
• Kenny Wayne Lynn, M.D.
• Mary Lillian Mack, R.N.
• Carrie Mackerwicz
• Rachel Macmillan, OTR/L
• Spencer J. Madell, MD
• Kendra Paige Madewell, FNP-C

• All providers in Cookeville, TN
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.