Individual provider Active NPI

Jessica Erin Foutch, FNP-C

  • Family Nurse Practitioner
  • Hixson, TN
National Provider Identifier
1992454474
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31424 Issued in TN
Practice address
1039 Executive Dr Ste 101
Hixson, TN 37343-7900
Phone
(423) 874-0125
Fax
(423) 874-0154
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31424 TN Primary

Addresses

Primary practice location

1039 Executive Dr Ste 101
Hixson, TN 37343-7900

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 497-5355

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
I20220330000048 TN Practitioner - Nurse Practitioner 5991191033 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
31424TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2022 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Jun 1, 2022 Accepting new patients
Galen Medical Group, PC Family CurrentSince Mar 1, 2022 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients

Locations

900 E 3rd St
Chattanooga, TN 37403
Phone (423) 778-5437

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

1635 Gunbarrel Rd
Ste 410
Chattanooga, TN 37421
Phone (423) 778-5437

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

1039 Executive Dr
Ste 101
Hixson, TN 37343
Phone (423) 874-0125

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 5

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1992454474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900",
            "telephone_number": "423-874-0125",
            "fax_number": "423-874-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUTCH",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.