Individual provider Active NPI

Douglas Adam Jentilet, M.D.

  • Emergency Medicine Physician
  • Knoxville, TN
National Provider Identifier
1255372439
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25747 Issued in WV
Practice address
1901 W Clinch Ave
Knoxville, TN 37916-2307
Phone
(865) 541-1111
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25747 WV Primary

Addresses

Primary practice location

1901 W Clinch Ave
Knoxville, TN 37916-2307

Mailing address

3200 Maccorkle Avenue SE
Emergency Department
Charleston, WV 25304
Phone (304) 388-4172

Other identifiers 4

IdentifierTypeStateIssuer
4122982OtherTNBLUE CROSS
P00333205OtherTNRAILROAD MEDICARE
3819457MedicaidTN
4152067OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WV, WI, VA, IL, NC6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20061004000358 TN Practitioner - Emergency Medicine 5395634620 Reassigns benefits to 2 organizations
I20140929002256 WV Practitioner - Emergency Medicine 5395634620 Reassigns benefits to 5 organizations
I20170531000565 WI Practitioner - Emergency Medicine 5395634620
I20171017000046 VA Practitioner - Emergency Medicine 5395634620 Reassigns benefits to 1 organization
I20180531000023 IL Practitioner - Emergency Medicine 5395634620 Reassigns benefits to 1 organization
I20201005001901 NC Practitioner - Emergency Medicine 5395634620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Hospital IncGroup PAC ID 3375444524, 155 clinicians

Practice addresses (Care Compare)

2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 260-1443

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City Hospital Inc Current Accepting new patients
City Hospital, Inc. Emergency Medicine CurrentSince Jun 2, 2025 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Emergency Services Midwest SC Emergency Medicine CurrentSince Apr 9, 2018 Accepting new patients
Health Care Alliance, Inc. Emergency Medicine CurrentSince Jun 25, 2014 Accepting new patients
Princeton Community Hospital Assn Inc. Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Feb 1, 2007 Accepting new patients
Charleston Area Medical Center, Inc. Emergency Medicine CurrentSince Jan 23, 2023 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Dec 27, 2013 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Jul 2, 2014 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Jun 1, 2021 Accepting new patients
Princeton Community Hospital Assn., Inc. CurrentSince Jun 1, 2021 Accepting new patients
Tennessee Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Emergency Department Physicians, P.C. Emergency Medicine Past Accepting new patients

Locations

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

800 Tilghman Dr
Dunn, NC 28334
Phone (910) 230-7800

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

500 Cherry St
Bluefield, WV 24701
Phone (304) 324-2614

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

122 12th St
Princeton, WV 24740
Phone (304) 487-7061

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Interoperability endpoints

  • Direct secure messaging: djentilet179912@direct.wvuhsdirect.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1255372439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVENUE SE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162307",
            "telephone_number": "865-541-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENTILET",
        "first_name": "DOUGLAS",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "25747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4122982",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00333205",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3819457",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4152067",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.