Pradumna S Jain, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD0000026667 Issued in TN

Practice address

9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521

Phone

(865) 470-4130

Fax

(865) 694-1655

NPI assigned

Aug 18, 2006

Last updated

Feb 14, 2020By 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Alternative Counseling Center

  • Community/Behavioral Health Agency
  • Knoxville, TN
  • NPI 1376715482
  NPD (past)
• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD (past)
• Parkwest Medical Center

  dba Peninsula Lighthouse Peninsula Outpatient Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1154303162
  NPD (past)
• Parkwest Medical Center

  dba Peninsula Div Parkwest MC

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  NPD (past)
• Parkwest Medical Center

  dba Peninsula Hospital A Division of Parkwest Medical Center

  • Psychiatric Hospital
  • Louisville, TN
  • NPI 1558343566
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1306950126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE D200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234521",
            "telephone_number": "865-470-4130",
            "fax_number": "865-694-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE D200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234521",
            "telephone_number": "865-470-4130",
            "fax_number": "865-694-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3105 Essary Dr",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379182409",
            "country_code": "US",
            "telephone_number": "865-687-8990",
            "fax_number": "865-687-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "PRADUMNA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000026667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "3112481",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "257338000",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095083",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rami Jadallah, MD
• Sukesh Joseph Jadav, PMHNP
• Delfin Jadol, PA-C
• Ronald K Jaekle, M.D.
• Somar Jahed
• Joan Jakab
• Georgia Jakes, NCC
• Janetta Jamerson, PH.D.
• James Bertram Solomon (Knoxville Spine and SPorts)
• James E Fox MD PLLC (Active Pain Treatment)

• Psychiatry Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.