Individual provider Active NPI

Jonathon Srour, DPM

  • Foot & Ankle Surgery Podiatrist
  • Cookeville, TN
National Provider Identifier
1386178705
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
932 Issued in TN
Practice address
105 S Willow Ave
Cookeville, TN 38501-4667
Phone
(931) 526-9518
Fax
(931) 372-0087
NPI assigned
Apr 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 932 TN Primary

Addresses

Primary practice location

105 S Willow Ave
Cookeville, TN 38501-4667

Mailing address

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230109002249 TN Practitioner - Podiatry 9830514587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

335 W Spring St
Cookeville, TN 38501-3125
Phone (931) 526-9518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue94
Removal of skin lesions1-10
Removal of nail tissue178
Removal or shaving of skin growth83
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
932TNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC CurrentSince Feb 1, 2023 Accepting new patients
Campbell Clinic PC CurrentSince Feb 1, 2023 Accepting new patients
CC Bpci PLC Past Accepting new patients
Campbell Clinic Past Accepting new patients

Locations

107 Health Care Dr
Carthage, TN 37030
Phone (615) 328-3390

317 W Spring St
Cookeville, TN 38501
Phone (931) 520-9250

335 W Spring St
Cookeville, TN 38501
Phone (931) 303-0446

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

35 Taylor Ave
Crossville, TN 38555
Phone (865) 483-8478

310 Oak St
Livingston, TN 38570
Phone (931) 403-0559

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jonathon.srour.1@1366.direct.athenahealth.com

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 and National Provider Directory roles.

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1386178705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "901-759-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014667",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUR",
        "first_name": "JONATHON",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.