Active NPI
Jerry Jaggers Embry, M.D.
- Psychiatry Physician
- Knoxville, TN
National Provider Identifier
1427184696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD0000006080
- Practice address
- 7632 Gleason Dr
Knoxville, TN 37919-6818 - Phone
- (865) 470-2719
- Fax
- (865) 694-4784
- NPI assigned
- Feb 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD0000006080 | TN | Primary |
Addresses
Primary practice location
7632 Gleason Dr
Knoxville, TN 37919-6818
Mailing address
7632 Gleason Dr
Knoxville, TN 37919-6818
Phone (865) 470-2719
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NN0066727 | Other | UNITED BEHAVIORAL HEALTH | |
| 3305434 | Other | AETNA PROVIDER NUMBER | |
| NN0066727 | Other | PIN # | |
| 3145120 | Medicaid | TN | |
| 2004724 | Other | TN | BCBS OF TENN. PIN # |
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 |
|---|---|---|---|
| MD0000006080 | TN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427184696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7632 GLEASON DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379196818",
"telephone_number": "865-470-2719",
"fax_number": "865-694-4784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7632 GLEASON DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379196818",
"telephone_number": "865-470-2719",
"fax_number": "865-694-4784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMBRY",
"first_name": "JERRY",
"middle_name": "JAGGERS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TN",
"license": "MD0000006080",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "NN0066727",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "3305434",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN #",
"identifier": "NN0066727",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3145120",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TENN. PIN #",
"identifier": "2004724",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.