Active NPI
Jonathan L Klein, M.D.
- Hematology (Pathology) Physician
- Maryville, TN
National Provider Identifier
1114239308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Pathology) Physician
- License
- 2010003222
- Practice address
- 250 E Broadway Ave
Maryville, TN 37804-5782 - Phone
- (865) 380-9746
- NPI assigned
- Jul 5, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Pathology) Physician | 207ZH0000X | 2010003222 | MO | Primary |
| Anatomic Pathology Physician | 207ZP0101X | 2010003222 | MO | |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 2010003222 | MO | |
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | 487634 | TN |
Addresses
Primary practice location
250 E Broadway Ave
Maryville, TN 37804-5782
Mailing address
250 E Broadway Ave
Maryville, TN 37804-5782
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 487634 | TN | MD | Molecular Genetic Pathology (Pathology) Physician |
| 2010003222 | MO | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1114239308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E BROADWAY AVE",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E BROADWAY AVE",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045782",
"telephone_number": "865-380-9746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "JONATHAN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-05",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZH0000X",
"taxonomy_group": "",
"desc": "Pathology, Hematology",
"state": "MO",
"license": "2010003222",
"primary": true
},
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "MO",
"license": "2010003222",
"primary": false
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "MO",
"license": "2010003222",
"primary": false
},
{
"code": "207ZP0007X",
"taxonomy_group": "",
"desc": "Pathology, Molecular Genetic Pathology",
"state": "TN",
"license": "487634",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.