Individual provider Active NPI

Jeremy Luke Rawson, M.D.

  • General Practice Physician
  • Monroe, LA
National Provider Identifier
1356789127
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
56782 Issued in TN
Practice address
309 Jackson St
Monroe, LA 71201-7407
Phone
(662) 231-8260
Fax
(318) 966-8788
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 56782 TN Primary

Addresses

Primary practice location

309 Jackson St
Monroe, LA 71201-7407

Mailing address

309 Jackson St
Monroe, LA 71201-7407
Phone (662) 231-8260

Other practice location 1

5304 Custis Ln
Knoxville, TN 37920-3773
Phone (662) 231-8260

Other practice location 2

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 305-9340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220329000492 TN Practitioner - General PracticePractitioner - Family Practice 2961646609 Reassigns benefits to 1 organization
I20220425000127 MS Practitioner - General Practice 2961646609 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56782TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Jan 6, 2022 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Jul 5, 2022 Accepting new patients

Locations

460 Briarwood Dr
Ste 400
Jackson, MS 39206
Phone (601) 203-1016

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1356789127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017407",
            "telephone_number": "662-231-8260",
            "fax_number": "318-966-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017407",
            "telephone_number": "662-231-8260",
            "fax_number": "318-966-8788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5304 Custis Ln",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379203773",
            "country_code": "US",
            "telephone_number": "662-231-8260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1924 Alcoa Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAWSON",
        "first_name": "JEREMY",
        "middle_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "56782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.