Active NPI
John Powell, PA
- Physician Assistant
- Johnson City, TN
National Provider Identifier
1508894437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0000000508
- Practice address
- 101 Med Tech Pkwy
Suite 200
Johnson City, TN 37604-4007 - Phone
- (423) 232-6120
- NPI assigned
- Jun 29, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0000000508 | TN | Primary |
Addresses
Primary practice location
101 Med Tech Pkwy
Suite 200
Johnson City, TN 37604-4007
Mailing address
101 Med Tech Pkwy
Suite 200
Johnson City, TN 37604-4001
Phone (423) 232-6120
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TN0115 | Other | TN | JOHN DEERE (JC) |
| P00102484 | Other | TN | MEDICARE RAILROAD |
| 4101375 | Other | TN | BLUE CROSS/BLUE SHIELD |
| TN0116 | Other | TN | JOHN DEERE (KPT) |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503964800000",
"number": "1508894437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MED TECH PKWY",
"address_2": "SUITE 200",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044001",
"telephone_number": "423-232-6120",
"fax_number": "423-232-6125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MED TECH PKWY",
"address_2": "SUITE 200",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044007",
"telephone_number": "423-232-6120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "JOHN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2017-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA0000000508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE (JC)",
"identifier": "TN0115",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00102484",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "4101375",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE (KPT)",
"identifier": "TN0116",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.