Individual provider Active NPI

Parker Panovec, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1003883141
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD25499 Issued in TN
Practice address
2859 Highway 45 Byp
Jackson, TN 38305-3618
Phone
(731) 660-8360
Fax
(731) 664-7928
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25499 TN Primary

Addresses

Primary practice location

2859 Highway 45 Byp
Jackson, TN 38305-3618

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Other identifiers 1

IdentifierTypeStateIssuer
3083246MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25499TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA Family Medicine CurrentSince Jun 30, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Jackson Clinic PA PastSince Jun 30, 2002 Accepting new patients

Locations

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360

4039 Highland St
Milan, TN 38358
Phone (731) 660-8755

Interoperability endpoints

  • Direct secure messaging: parker.panovec.1@20174.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1003883141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-422-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 HIGHWAY 45 BYP",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053618",
            "telephone_number": "731-660-8360",
            "fax_number": "731-664-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOVEC",
        "first_name": "PARKER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD25499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083246",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.