Jon Brooks Boroughs, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

45939 Issued in TN

Practice address

1039 Executive Dr Ste 101
Hixson, TN 37343-7900

Phone

(423) 874-0125

Fax

(423) 874-0154

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Galen Medical Group, PC

  • Internal Medicine Physician
  • Hixson, TN
  • NPI 1346250057

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1497956148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900",
            "telephone_number": "423-874-0125",
            "fax_number": "423-874-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROUGHS",
        "first_name": "JON",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "45939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Nicole Boddy, N.P.
• Steven Wayne Bohr, CRNA
• Kelli Boitnott
• Madeline Boote, PTA
• Brenda Sue Borkgren, NP-C
• Shauna Borrero, RDN, LD, CNSC
• Stephanie Bougrat
• Bounceback Physical Therapy LLC
• Allyson Bowman, LPC-MHSP
• Sarah Morgan Lee Bowman, CPNP

• Pediatrics Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.