JELLICO WELLNESS BEHAVIORAL HEALTH
NPI 1952805319
Nurse Practitioner - Psychiatric/Mental Health in Jellico, TN
NPI Status: Active since March 21, 2018
Contact Information
1811 5TH ST
JELLICO, TN
ZIP 37762
Phone: (615) 335-3430
- Organization
- Nurse Practitioner
- Psychiatric/Mental Health
- CLIA Number: 44D2150432
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 06-24-2026
About JELLICO WELLNESS BEHAVIORAL HEALTH
This page provides the complete NPI Profile along with additional information for Jellico Wellness Behavioral Health, a provider established in Jellico, Tennessee operating as a Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1952805319 assigned on March 2018. The practitioner's primary taxonomy code is 363LP0808X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Jellico Wellness Behavioral Health. The authorized official of this NPI record is Nicole Asante Family Nurse Practit (Fnp/president)
- NPI
- 1952805319
- Provider Legal Name
- JELLICO WELLNESS AND CONVENIENT CARE CLINIC, LLC
- Other Organization Name
- JELLICO WELLNESS BEHAVIORAL HEALTH
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1811 5TH ST JELLICO, TN 37762
- Location Phone
- (615) 335-3430
- Mailing Address
- 1811 5TH ST JELLICO, TN 37762
- Mailing Phone
- (423) 455-3032
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-21-2018
- Last Update Date
- 09-05-2024
- Code Navigator
A nurse practitioner (NP) like Jellico Wellness Behavioral Health is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 2 | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 14174 (TN) |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1527342 | MEDICAID (05) | TN | |
| 1031508098 | OTHER (01) | TN | MEDICARE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D2150432
- Facility Type
- Practitioner Other
- Certificate Effective Date
- June 25, 2024
- Certificate Expiration Date
- June 24, 2026
- Laboratory Director
- NICOLE RUSSELL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jellico Wellness Behavioral Health to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 5 | 2 | 8 | 0 | 5 | 3 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 10 | 2 | 16 | 0 | 10 | 3 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 0 + 2 + 1 + 6 + 0 + 1 + 0 + 3 + 2 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1952805319 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
NICOLE ANN ASANTE FNP, PMHNP
Nurse Practitioner
(Psychiatric/Mental Health)
1811 5TH ST
JELLICO, TN
ZIP 37762
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1952805319, enumerated as an "organization" on March 21, 2018.
The provider is located at 1811 5TH ST JELLICO, TN 37762 and the phone number is (615) 335-3430.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
