Individual provider Active NPI

Jeswin Brigit John

  • Pediatrics Physician
  • Chattanooga, TN
National Provider Identifier
1154709756
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
58158 Issued in TN
Practice address
910 Blackford St
Chattanooga, TN 37403
Phone
(423) 778-6107
Fax
(423) 778-6958
NPI assigned
May 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 58158 TN Primary

Addresses

Primary practice location

910 Blackford St
Chattanooga, TN 37403

Mailing address

910 Blackford St
Chattanooga, TN 37403-1405
Phone (423) 778-6107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190828003254 IL Practitioner - Pediatric MedicinePractitioner - Hospitalist 9638480734 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58158TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Memorial Hospital, Inc Current Accepting new patients
Carle Health Care Incorporated CurrentSince Aug 13, 2019 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Aug 28, 2023 Accepting new patients
Richland Memorial Hospital, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jjohnmd285220@carlehiedirect.net

Organizations & group practices 5

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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1154709756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031405",
            "telephone_number": "423-778-6107",
            "fax_number": "423-778-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BLACKFORD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37403",
            "telephone_number": "423-778-6107",
            "fax_number": "423-778-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JESWIN",
        "middle_name": "BRIGIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "58158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.