Active NPI
Prathmesh Jain, M.D.
- Specialist
- Jackson, TN
National Provider Identifier
1386827236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 618
- Practice address
- 569 Skyline Dr
Suite 100
Jackson, TN 38301-3911 - Phone
- (731) 427-7888
- Fax
- (731) 265-4168
- NPI assigned
- Dec 14, 2007
- Last updated
- Aug 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 618 | TN | Primary |
Addresses
Primary practice location
569 Skyline Dr
Suite 100
Jackson, TN 38301-3911
Mailing address
569 Skyline Dr
Suite 100
Jackson, TN 38301-3911
Phone (731) 427-7888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3709355 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 618 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218153600000",
"number": "1386827236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "569 SKYLINE DR",
"address_2": "SUITE 100",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013911",
"telephone_number": "731-427-7888",
"fax_number": "731-265-4168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "569 SKYLINE DR",
"address_2": "SUITE 100",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013911",
"telephone_number": "731-427-7888",
"fax_number": "731-265-4168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "PRATHMESH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-14",
"last_updated": "2008-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "618",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3709355",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
- Jackson-Madison County General Hospital District (Medical Center Home Health)
- Jackson-Madison County General Hospital District
- Don M Jackson, CRNA
- Sara W Jackson, APRN
- Cody Allen Jacobs, PHARMD
- James a Jones Jr
- James T Craig Jr MD Inc (Craig Orthopedic Clinic)
- Amaris Airica James, RBT
- David Franklin James, M.D.
- Hunter James, MSN, AGACNP-BC, RNFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.