Broughton D Jolley, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

21958 Issued in TN

Practice address

135 W Ravine Rd
Suite 5-B
Kingsport, TN 37660-3847

Phone

(423) 224-3460

Fax

(423) 224-3465

NPI assigned

Aug 9, 2005

Last updated

Apr 12, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Anesthesiology

Education

East Tennessee State University Quillen College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Anesthesiology of Tennessee PCGroup PAC ID 9931001922, 296 clinicians

Laurel Falls Anesthesiologists PLLCGroup PAC ID 8921452673, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011
• Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bjolley872661@direct.ghs.myhfn.org
• Direct secure messaging: broughton.jolley.p1@direct.bmpg.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment Care Compare group NPD
• Laurel Falls Anesthesiologists, PLLC

  • Anesthesiology Physician
  • Maryville, TN
  • NPI 1942980875
  Medicare reassignment Care Compare group NPD

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

• Metro Knoxville Hma LLC

  dba Tennova Healthcare North Knoxville Medical Center

  • General Acute Care Hospital
  • Powell, TN
  • NPI 1043292899
  Care Compare affiliation
• Prisma Health - Blount Memorial Hospital Inc.

  dba Blount Memorial Hospital

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1235130717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303535510",
            "telephone_number": "844-294-5114",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "SUITE 5-B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "BROUGHTON",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "21958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHC CARE ADMINISTRATORS",
            "identifier": "00013859",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050043321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF TN",
            "identifier": "3045725",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3082522",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5704791",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "240137",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Johnson, FNP
• Seth D Johnson, CRNA
• Toby N Johnson, M.A., CCC-A
• William Kendall Johnson, PAC
• Perry L Joiner III, DMD
• Aaron Michelle Strouth Jones
• Alisha Jones, FNP
• Blakely Kyle Jones, O.D.
• Brandon Douglas Jones, PA-C
• Elizabeth Ann Jones, MA

• Anesthesiology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.