Jason Vance MD a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JASON VANCE MD A MEDICAL CORPORATION

Practice address

7586 Catchfly Dr
Ooltewah, TN 37363-1725

Phone

(530) 966-5454

NPI assigned

Apr 9, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jason Vance, MD

Title

Owner

Phone

(530) 966-5454

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1467959155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7586 CATCHFLY DR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373631725",
            "telephone_number": "530-966-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7586 CATCHFLY DR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373631725",
            "telephone_number": "530-966-5454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6480 Pentz Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Paradise",
            "state": "CA",
            "postal_code": "959693672",
            "country_code": "US",
            "telephone_number": "530-872-6652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JASON VANCE MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-966-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Andrew Keith Johnson, DPT
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• Jenica Johnson, RDN, LDN

• Family Medicine Physician in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.