Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Monroe Visca

Individual provider Surgical Physician Assistant · NPI 1710829742

Jack Monroe Visca is a Physician Assistant in Crossville, Tennessee. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in Tennessee.

Years since qualifying
1
Licensed in
TN
In the registry since
2026
Specialties on file
2

Practice location Address checks out

49 Cleveland St Ste 350
Crossville, TN 38555-2898
Phone: (931) 459-7720
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 421 S Main St, Crossville, TN 38555-5031 — (931) 484-9511

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 7121 (TN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 7121 (TN)

Record details

NPI number1710829742
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 8, 2026
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026
Mailing address7331 Cresthill Dr Apt E5, Knoxville, TN 37919-5918

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare