Jerod K Williams

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8231

Phone

(423) 869-6723

NPI assigned

Jul 18, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1063250488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 BUCKNELL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379383137",
            "telephone_number": "916-955-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 CUMBERLAND GAP PKWY",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528231",
            "telephone_number": "423-869-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEROD",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Christine Wantz
• Tyler Webb
• Gage Hunter Cas Weddington
• Abby Michelle Wedolowski
• Brooke Williams, PTA
• Ashley N Wilson, NURSE PRACTITIONER
• Casey Wilson, APN
• Lauren Kristine Wilson, DPT
• Alec Wiscombe
• Daniel Raymond Wood

• Student in an Organized Health Care Education/Training Program in Harrogate, TN
• Providers in Harrogate, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.