Individual provider Active NPI

Jillian McClintock, FNP

  • Nurse Practitioner
  • Hermitage, TN
National Provider Identifier
1992306609
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
30217 Issued in TN
Practice address
5653 Frist Blvd Ste 434
Hermitage, TN 37076-2065
Phone
(615) 871-9996
NPI assigned
Nov 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1003083 TX
Nurse Practitioner 363L00000X 30217 TN Primary

Addresses

Primary practice location

5653 Frist Blvd Ste 434
Hermitage, TN 37076-2065

Mailing address

2004 Hayes St
Ste 800
Nashville, TN 37203-2659
Phone (615) 329-0570

Other identifiers 2

IdentifierTypeStateIssuer
1003083OtherTXAPRN-CNP
F05200486OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

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
I20211011001067 TN Practitioner - Nurse Practitioner 6507264272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee Oncology PLLCGroup PAC ID 4688586134, 355 clinicians

Practice addresses (Care Compare)

5653 Frist Blvd
Suite 434
Hermitage, TN 37076-2065
Phone (615) 871-9996

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30217TNMDNurse Practitioner
1003083TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Oncology PLLC CurrentSince Sep 3, 2021 Accepting new patients

Locations

5653 Frist Blvd
Ste 434
Hermitage, TN 37076
Phone (615) 871-9996

121 Bear Xing
Ste 200
Mt Juliet, TN 37122
Phone (615) 871-9996

2004 Hayes St
Ste 800
Nashville, TN 37203
Phone (615) 514-3023

1750 Cedar Ln
Ste 200
Tullahoma, TN 37388
Phone (615) 333-2481

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1992306609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 HAYES ST",
            "address_2": "STE 800",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032659",
            "telephone_number": "615-329-0570",
            "fax_number": "615-329-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5653 FRIST BLVD STE 434",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762065",
            "telephone_number": "615-871-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "JILLIAN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-08",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1003083",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "30217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN-CNP",
            "identifier": "1003083",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F05200486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

Verify at the official NPI Registry.