MYCAH JACK FNP-BC
NPI 1396481693
Nurse Practitioner - Family in Knoxville, TN

Active since May 09, 2022PECOS Enrolled
1930 ALCOA HWY, KNOXVILLE, TN 37920(865) 263-2400 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mycah Jack Fnp-bc NPPES

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

MYCAH JACK FNP-BC (NPI 1396481693) is an individual family provider in Knoxville, Tennessee, licensed in Tennessee (31108) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396481693
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMYCAH JACKCredential: FNP-BC
Location Address1930 ALCOA HWYKnoxville, TN 37920-1500
Mailing Address4209 Deerfield RdKnoxville, TN 37921-3219 · (865) 313-3709
Sole ProprietorNo
Enumeration DateMay 9, 2022
NPPES CertifiedMay 9, 2022
NPI 1396481693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in TN · 31108
1930 ALCOA HWY, Knoxville, TN 37920

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mycah Jack Fnp-bc 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 37920 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
1930 ALCOA HWY, STE 335
KNOXVILLE, TN 37920
Plastic Surgery
1930 ALCOA HWY, SUITE 235
KNOXVILLE, TN 37920
Nurse Practitioner (Neonatal)
1930 ALCOA HWY, SUITE 145
KNOXVILLE, TN 37920
Nurse Practitioner (Family)
1930 ALCOA HWY, BUILDING A SUITE 435
KNOXVILLE, TN 37920
Specialist
1930 ALCOA HWY, SUITE 145
KNOXVILLE, TN 37920
Pediatrics (Neonatal-Perinatal Medicine)
1930 ALCOA HWY, SUITE 145
KNOXVILLE, TN 37920
Internal Medicine (Gastroenterology)
1930 ALCOA HWY
KNOXVILLE, TN 37920
Dentist (General Practice)
1930 ALCOA HWY, MEDICAL BUILDING A, SUITE 340
KNOXVILLE, TN 37920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mycah Jack's NPI number?

The NPI number for Mycah Jack is 1396481693. It was assigned to this individual provider in the NPPES registry on May 9, 2022.

Where is Mycah Jack located?

Mycah Jack practices at 1930 Alcoa Hwy, Knoxville, TN 37920. The listed phone number is (865) 263-2400.

What is Mycah Jack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mycah Jack enrolled in Medicare?

Yes. Mycah Jack is registered in the Medicare PECOS enrollment system.

What insurance does Mycah Jack accept?

Health plans from UnitedHealthcare list Mycah Jack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mycah Jack was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.