JP PRIME HEALTH PLLC (NPI# 1346714714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346714714 |
| Entity Type | Organization |
| Organization Name | JP PRIME HEALTH PLLC |
| Practice Address |
111 Ussery Rd Clarksville TN 37043-4530 |
| Mailing Address |
906 Glenraven Dr Clarksville TN 37043-8296 |
| Practice Telephone | 9316470269 |
| Practice Fax Number | 9315538129 |
| Mailing Telephone | 9314363668 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | JENNIFER PENDERGRAST (NP) |
| Authorized Official Telephone | 9316470269 |
| Authorized Official Credential | APN-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 906 Glenraven Dr, Clarksville, TN 370438296 | 9316470269 |
| Street Address |
111 USSERY RD |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37043-4530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477595775 | Integrity Healthcare of Clarksville, LLC | Skilled Nursing Facility | 111 Ussery Rd, Clarksville, TN 37043-4530 | 2006-06-12 |
| 1427583004 | Clarksville Operating Group LLC | Skilled Nursing Facility | 111 Ussery Rd, Clarksville, TN 37043-4530 | 2017-04-20 |
| 1093879207 | Ira G Hartman | Nurse Practitioner | 111 Ussery Rd, Clarksville, TN 37043-4530 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477196004 | Brie Lajeret | Nurse Practitioner | 800 Weatherly Dr Ste 201b, Clarksville, TN 37043-8958 | 2019-10-27 |
| 1588212716 | Sabina G Sambat | Nurse Practitioner | 6100 Daylong Ln Ste 105, Clarksville, MD 21029-1631 | 2019-08-30 |
| 1265991871 | Jane Holt | Nurse Practitioner | 647 Dunlop Ln Ste 101, Clarksville, TN 37040-5165 | 2019-03-14 |
| 1629335120 | Leanne S Balmer | Nurse Practitioner | 775 Weatherly Dr, Ste F, Clarksville, TN 37043-8942 | 2012-04-20 |
| 1588980908 | Tommy Lewis Thompson Jr. | Nurse Practitioner | 1861 River Rd, Clarksville, TN 37040-7437 | 2010-04-09 |
| 1831360411 | Alexandria Nicole Duncan | Nurse Practitioner | 230 Dover Road, Clarksville, TN 37042 | 2008-03-21 |
| 1639340680 | Cumberland View Clinic LLC | Nurse Practitioner | 1749 Highway 48, Clarksville, TN 37040-7427 | 2008-03-18 |
| 1689643991 | Denise Polen Brooks | Nurse Practitioner | 420 W Jefferson Ave, Clarksville, IN 47129-1820 | 2006-03-17 |
| 1114921681 | Jane Faith Kapustin | Nurse Practitioner | 5005 Signal Bell Ct, Ste 102, Clarksville, MD 21029-2607 | 2005-06-11 |
| 1356810089 | Sara Tenille Cottrell | Nurse Practitioner | 647 Dunlop Ln Ste 200, Clarksville, TN 37040-5165 | 2018-11-26 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37043 |
Please comment or provide details below to improve the information on JP PRIME HEALTH PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.