Individual provider Active NPI

John Gannaway

  • Mental Health Counselor
  • Jackson, TN
National Provider Identifier
1134588437
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
238 Summar Dr
Jackson, TN 38301-3906
Phone
(731) 541-8200
Fax
(731) 660-8739
NPI assigned
Feb 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

238 Summar Dr
Jackson, TN 38301-3906

Mailing address

1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436
Phone (731) 660-7971

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211002730 TN Practitioner - Mental Health Counselor 5991231185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways of Tennessee IncGroup PAC ID 6507833613, 42 clinicians

Practice addresses (Care Compare)

1270 Union University Dr
Suite D
Jackson, TN 38305-3856
Phone (731) 265-6540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6903TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways of Tennessee, Inc. CurrentSince Sep 12, 2024 Accepting new patients

Locations

238 Summar Dr
Jackson, TN 38301
Phone (731) 541-8200

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

1270 Union University Dr
Ste D
Jackson, TN 38305
Phone (731) 265-6450

930 Mount Zion Rd
Union City, TN 38261
Phone (731) 885-9333

Organizations & group practices 1

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": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1134588437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013906",
            "telephone_number": "731-541-8200",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNAWAY",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.