Individual provider Active NPI

John R Reisser, MD

  • Surgery Physician
  • Maryville, TN
National Provider Identifier
1104904028
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17966 Issued in TN
Practice address
250 BMH Physicians Office BLDG
Maryville, TN 37804-5904
Phone
(865) 980-5244
Fax
(865) 980-5245
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 17966 TN Primary
Vascular Surgery Physician 2086S0129X 17966 TN

Addresses

Primary practice location

250 BMH Physicians Office BLDG
Maryville, TN 37804-5904

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other identifiers 1

IdentifierTypeStateIssuer
3806185MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20100921000569 TN Practitioner - General SurgeryPractitioner - Vascular SurgeryPractitioner - Internal Medicine 5698890465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
University of Tennessee, HSC, College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

250 BMH Physicians Office BLDG
Maryville, TN 37804-5904
Phone (865) 960-5244

Hospital & facility affiliations

  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
64.09
Promoting interoperability
98
Improvement activities
40
Cost
77.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Partners of East Tennessee, PLLC CurrentSince Feb 10, 2025 Accepting new patients
East Tennessee Medical Group, PC Surgery Past Accepting new patients

Locations

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

250 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5244

Interoperability endpoints

  • Direct secure messaging: jreisser864021@direct.ghs.myhfn.org
  • Direct secure messaging: john.reisser.p1@direct.bmpg.nextgenshare.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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1104904028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BMH PHYSICIANS OFFICE BLDG",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045904",
            "telephone_number": "865-980-5244",
            "fax_number": "865-980-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISSER",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "17966",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "17966",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3806185",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.