Jason Glen Funderburk, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

47153 Issued in TN

Practice address

116 Concord Rd
Suite 500
Knoxville, TN 37934-2940

Phone

(865) 777-6880

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Radiology

Education

Louisiana State University School of Medicine in New Orleans, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Great Falls Clinic Hospital Hospital, Great Falls, MT, CCN 270086

Merit-based Incentive Payment System (MIPS)

Final score

90.98 of 100Reported as apm

Quality

80.39

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.funderburk.1@25095.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4

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.

• Great Falls Clinic LLC

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1801897780
  Medicare reassignment Care Compare group NPD
• Bayfront Medical Center, Inc.

  • Diagnostic Radiology Physician
  • St Petersburg, FL
  • NPI 1841269644
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CMSC, LLC

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1639109978
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1104883966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CONCORD RD",
            "address_2": "SUITE 500",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342940",
            "telephone_number": "865-777-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CONCORD RD",
            "address_2": "SUITE 500",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342940",
            "telephone_number": "865-777-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "JASON",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME 93065",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "47153",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "4301102162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Fulton
• John Fultz
• Lauren Fultz
• Functional Pathways of Tennessee LLC
• Functional Pathways Preferred of Tennessee LLC
• Jeffrey Fuqua, M.D.
• Stephanie Sue Furman, M.S.O.T.
• Jessica Furner
• Kasey Furniss, MS CCC-SLP
• Jessica Lee Furrow

• Vascular & Interventional Radiology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Vascular & Interventional Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.