Active NPI
Jackson J Yium, MD
- Nephrology Physician
- Chattanooga, TN
National Provider Identifier
1467458885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 8325
- Practice address
- 960 E 3Rd St
Ste 208
Chattanooga, TN 37403-2104 - Phone
- (423) 778-2550
- NPI assigned
- Jun 21, 2005
- Last updated
- Jul 31, 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 8325 | TN | Primary |
Addresses
Primary practice location
960 E 3Rd St
Ste 208
Chattanooga, TN 37403-2104
Mailing address
975 E 3Rd St
Box 338
Chattanooga, TN 37403-2147
Phone (423) 648-9808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3154099 | 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 |
|---|---|---|---|
| 8325 | TN | MD | EEG Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Chrostowski, MD,PLLC | Past | Accepting new patients | |
| Chattanooga Kidney Centers, LLC | Past | Accepting new patients | |
| Jemison O. Bowers, MD | Past | Accepting new patients | |
| Ut Physicians Inc | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1467458885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 E 3RD ST",
"address_2": "BOX 338",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374032147",
"telephone_number": "423-648-9808",
"fax_number": "423-648-4570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 E 3RD ST",
"address_2": "STE 208",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374032104",
"telephone_number": "423-778-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIUM",
"first_name": "JACKSON",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-21",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TN",
"license": "8325",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3154099",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.