Individual Healthcare Provider
Beverly J Jacks, CNM, APRN
Provider's NPPES record last updated: December 4, 2012
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1003954595
- Primary Specialty
- Nurse Practitioner — Women's Health
- Practice Location
- Chattanooga, Tennessee
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 5:28 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Women's Health
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LW0102X Advanced Practice Midwife
Physician Assistants & Advanced Practice Nursing Providers
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling.
Taxonomy code 367A00000X
Provider-Reported License Information
- Nurse Practitioner (Tennessee)
- 5511
- Advanced Practice Midwife (Tennessee)
- 05511
Practice Locations
Practice Location
6116 Shallowford Rd
Suite 117
Chattanooga, Tennessee 37421-7201
Phone: (423) 702-5581
Record Information
- Enumeration Date
- February 5, 2007
- Provider's NPPES Record Last Updated
- December 4, 2012
- NPISignal NPPES Dataset
- August 2026
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