Individual provider Active NPI

John P Teilhet, PA-C

  • Medical Physician Assistant
  • Johnson City, TN
National Provider Identifier
1366754574
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1850 Issued in TN
Practice address
410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972
Phone
(423) 431-2460
Fax
(423) 431-2465
NPI assigned
Jul 6, 2010
Last updated
Feb 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1850 TN
Medical Physician Assistant 363AM0700X 1850 TN Primary
Surgical Physician Assistant 363AS0400X 1850 TN

Addresses

Primary practice location

410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972

Mailing address

410 N State of Franklin Rd Ste 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101221000837 TN Practitioner - Physician Assistant 5496943235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

410 N State of Franklin Rd
Suite 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

410 N State of Franklin Rd
Suite 140B
Johnson City, TN 37604-6971
Phone (423) 431-2460

4307 N Roan St
Suite 7
Johnson City, TN 37615-4973
Phone (423) 491-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1850TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Mar 5, 2021 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 5, 2021 Accepting new patients
Blue Ridge Medical Management Corporation Physician Assistant Past Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

410 N State of Franklin Rd
Ste 140
Johnson City, TN 37604
Phone (423) 431-2460

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1366754574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 140",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2460",
            "fax_number": "423-431-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD STE 140",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046972",
            "telephone_number": "423-431-2460",
            "fax_number": "423-431-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEILHET",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1850",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1850",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "1850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.