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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

JORDAN SCOTT NICKELS
NPI 1922929504
Nurse Practitioner - Family in Rogersville, TN

Active since July 21, 2026
300 PARK BLVD, ROGERSVILLE, TN 37857(423) 347-6021 Get Directions Write a Review

NPPES record added: July 21, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jordan Scott Nickels NPPES

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

JORDAN SCOTT NICKELS (NPI 1922929504) is an individual family provider in Rogersville, Tennessee, licensed in Tennessee (42437) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1922929504
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJORDAN SCOTT NICKELS
Location Address300 PARK BLVDRogersville, TN 37857-2912
Mailing Address300 Park BlvdRogersville, TN 37857-2912 · (423) 347-6021
Phone(423) 347-6021
Sole ProprietorNo
Enumeration DateJuly 21, 2026
NPPES CertifiedJuly 21, 2026
✔ NPI 1922929504 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
Licenses✔ Licensed in TN · 42437✔ Licensed in VA · 0024198030
300 PARK BLVD, Rogersville, TN 37857
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Other Providers at the Same Location NPPES 2

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

EDEN CHEYENNE HARMON FNP-C
Nurse Practitioner (Family)
300 PARK BLVD
ROGERSVILLE, TN 37857
Hawkins County (423) 347-6021
FAST PACE MEDICAL CLINIC PLLC
Clinic/Center (Urgent Care)
300 PARK BLVD
ROGERSVILLE, TN 37857
Hawkins County (423) 347-6022

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 Jordan Nickels's NPI number?

The NPI number for Jordan Nickels is 1922929504. It was assigned to this individual provider in the NPPES registry on July 21, 2026.

Where is Jordan Nickels located?

Jordan Nickels practices at 300 Park Blvd, Rogersville, TN 37857. The listed phone number is (423) 347-6021.

What is Jordan Nickels's specialty?

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

When was this NPI record last updated?

The NPPES record for Jordan Nickels was last updated on July 21, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.