Individual provider Active NPI

Julia Wegryn, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1447624457
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2860 Issued in TN
Practice address
1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2434
Phone
(865) 546-5111
NPI assigned
Nov 15, 2015
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2860 TN Primary

Addresses

Primary practice location

1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2434

Mailing address

1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2434
Phone (865) 546-5111

Other identifiers 1

IdentifierTypeStateIssuer
Q020596MedicaidTN

Other names 1

  • Mrs. Julia Namey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wegryn.julia@covenanthealth.cernerdirect.com

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
I20160427001016 TN Practitioner - Physician Assistant 5991004871 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Apr 1, 2016 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 1, 2016 Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Interoperability endpoints

  • Direct secure messaging: wegryn.julia@covenanthealth.cernerdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1447624457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE",
            "address_2": "SUITE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-546-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE",
            "address_2": "SUITE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-546-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGRYN",
        "first_name": "JULIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-15",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020596",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wegryn.julia@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1819 W Clinch Ave",
            "address_2": "Suite 108",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379162434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "NAMEY",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.