MRS. JESSICA ELAINE LIETZ FNP-C
NPI 1124262720
Nurse Practitioner - Primary Care in Fort Campbell, KY

Q: What is Jessica Lietz's NPI number?

The NPI number for Jessica Lietz is 1124262720. It was assigned to this individual provider in the NPPES registry on April 27, 2009.

Q: What is Jessica Lietz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Lietz was last updated on April 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 27, 2009PECOS Enrolled

650 JOEL DR, FORT CAMPBELL, KY 42223(270) 798-8400 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mrs. Jessica Elaine Lietz Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JESSICA ELAINE LIETZ FNP-C (NPI 1124262720) is an individual primary care provider in Fort Campbell, Kentucky, licensed in Tennessee (014113) and active in the NPI registry since April 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124262720

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameMRS. JESSICA ELAINE LIETZCredential: FNP-C

Location Address650 JOEL DRFort Campbell, KY 42223-5318

Mailing Address650 Joel DrFort Campbell, KY 42223-5318 · (270) 498-5656

Phone(270) 798-8400

Sole ProprietorNo

Enumeration DateApril 27, 2009

Last NPPES UpdateApril 14, 2025

NPPES CertifiedApril 14, 2025

✔ NPI 1124262720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in TN · 014113

650 JOEL DR, Fort Campbell, KY 42223

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jessica Elaine Lietz Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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