JACI KATE QUALLS (FNP-BC) – Family Nurse Practitioner, NPI 1194536367

JACI KATE QUALLS (FNP-BC) is a healthcare provider. based in Livingston, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 38006 (TN). The NPI Number for JACI KATE QUALLS (FNP-BC) is 1194536367

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JACI KATE QUALLS (FNP-BC)
NPI
1194536367
Phone
(931) 823-3030
Address
5751 BRADFORD HICKS DR
Enumeration Date
16 January 2025
Last Update Date
16 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9318233030
Graduation Year
2024 (2 years ago)
PAC ID
6507380714
Group Practice PAC ID
6103980305
Professional Enrollment ID
I20250409002528
Address ID
TN385702237LI5751XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for JACI KATE QUALLS (FNP-BC)

  • 5751 BRADFORD HICKS DR

    LIVINGSTON, TN 385702237

    Phone: (931) 823-3030

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250409002528INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38570)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103980305View full group profile
NameSpecialtyState
Family PracticeTN
Family PracticeTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

Where can patients find JACI KATE QUALLS (FNP-BC)'s NPI?
You can confirm JACI KATE QUALLS (FNP-BC) with NPI 1194536367; it appears in the national provider directory.
Is JACI KATE QUALLS (FNP-BC) active in the national directory?
JACI KATE QUALLS (FNP-BC)'s public NPI profile is in an active state.
Does JACI KATE QUALLS (FNP-BC) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for JACI KATE QUALLS (FNP-BC). Clinical services aligned with this taxonomy classification.
Where does public data place JACI KATE QUALLS (FNP-BC)?
The snapshot lists Livingston, Tennessee for JACI KATE QUALLS (FNP-BC); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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