Gyu Chang Jo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25572 Issued in TN

Practice address

205 Hospital Dr Ste a
MC Kenzie, TN 38201

Phone

(731) 352-7907

Fax

(731) 352-4459

NPI assigned

Apr 30, 2019

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Vanderbilt Bedford Hospital LLCGroup PAC ID 4082026695, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vanderbilt University Medical Center Hospital, Nashville, TN, CCN 440039
• Vanderbilt Wilson County Hospital Hospital, Lebanon, TN, CCN 440193

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gjo567876@direct.vumc.org

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.

• Vanderbilt Bedford Hospital, LLC

  • Internal Medicine Physician
  • Shelbyville, TN
  • NPI 1750977989
  Medicare reassignment Care Compare group NPD
• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  Medicare reassignment Care Compare group NPD
• Vanderbilt Integrated Providers, LLC

  dba Vanderbilt Integrated Providers

  • Family Medicine Physician
  • Tullahoma, TN
  • NPI 1982625091
  Medicare reassignment NPD
• Vanderbilt Integrated Providers, LLC

  dba Vanderbilt Integrated Center for Women's Health

  • Rural Health Clinic/Center
  • Tullahoma, TN
  • NPI 1265210843
  NPD

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

• Vanderbilt University Medical Center

  dba Vanderbilt Wilson County Hospital

  • General Acute Care Hospital
  • Lebanon, TN
  • NPI 1306889597
  Care Compare affiliation
• Vanderbilt University Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1396882205
  Care Compare affiliation

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1245894724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR STE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "38201",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "471 Sharondale Dr",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371294037",
            "country_code": "US",
            "telephone_number": "615-886-8262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320001",
            "country_code": "US",
            "telephone_number": "615-936-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "GYU",
        "middle_name": "CHANG",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-30",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjo567876@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• J. B. Johnsonius, D.D.S.
• Jennifer Rene Jennings, FNP-BC
• John E Motheral
• Tamiko Johns, LPN
• David Andrew Johnson, MSW, LMFT
• Courtney Kee, ED. S.
• Mary Keen, DPH

• Family Nurse Practitioner in McKenzie, TN
• Providers in McKenzie, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.