Jackie A Church, APN - Medicare in Kingsport, TN

Jackie A Church, APN is a medicare enrolled "Nurse Practitioner - Family" in Kingsport, Tennessee. Her current practice location is 4600 Fort Henry Dr, Kingsport, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 224-3950.

Jackie A Church is licensed to practice in Tennessee (license number APN12537) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629126321.

Contact Information

Jackie A Church, APN
4600 Fort Henry Dr,
Kingsport, TN 37663-2617
(423) 224-3950
Not Available

Map and Direction




Provider's Profile

Full NameJackie A Church
GenderFemale
Speciality
Experience Years
Location4600 Fort Henry Dr, Kingsport, Tennessee
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jackie A Church attended and graduated from in
  NPI Data:
  • NPI Number: 1629126321
  • Provider Enumeration Date: 01/08/2007
  • Last Update Date: 10/18/2023
  Medicare PECOS Information:
  • PECOS PAC ID:
  • Enrollment ID:

Medical Identifiers

Medical identifiers for Jackie A Church such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629126321NPI-NPPES
P01171831OtherTNRR MEDICARE
1629126321MedicaidNC
1629126321MedicaidVA
3341016MedicaidTN
7100236150MedicaidKY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 143764 (Tennessee)Secondary
363L00000XNurse Practitioner 0024187900 (Virginia)Secondary
363L00000XNurse Practitioner 5018685 (North Carolina)Secondary
363LF0000XNurse Practitioner - Family APN12537 (Tennessee)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie A Church is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jackie A Church, APN
1021 W Oakland Ave Ste 310,
Johnson City, TN 37604-2192

Ph: (423) 302-6565
Jackie A Church, APN
4600 Fort Henry Dr,
Kingsport, TN 37663-2617

Ph: (423) 224-3950

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.