Jason L Altman, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Johnson City, TN
NPI 1609103126 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1609103126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 23142 (TN)
- Practice address
- 109 W Watauga Ave
Johnson City, TN 37604-5668 - Phone
- (423) 232-2600
- Fax
- (423) 467-3644
- NPI assigned
- Nov 4, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellmont Medical Associates Inc
Practice addresses (Care Compare)
111 W Stone Dr
Kingsport, TN 37660-6027
701 Med Tech Pkwy
Suite 200
Johnson City, TN 37604-2371
Phone (423) 302-3480
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191118000599 | TN | Practitioner - Nurse Practitioner | 3476985292 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000162518 | TN | MD | Registered Nurse |
| 23142 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontier Health | Current |
Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current |
Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Frontier Health | Current |
Accepting new patients | |
| Wellmont Medical Associates Inc | Current |
Accepting new patients | |
| Wellmont Health System | Current | Accepting new patients | |
| Frontier Health | Past | Accepting new patients |
Locations
109 W Watauga Ave
Johnson City, TN 37604
Phone (423) 232-2600
701 Med Tech Pkwy
Ste 200
Johnson City, TN 37604
Phone (423) 283-7302
1167 Spratlin Park Dr
Johnson City, TN 37615
Phone (423) 232-2670
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
701 Med Tech Pkwy
Ste 201
Johnson City, TN 37604
Phone (423) 283-7302
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
Interoperability endpoints
- jaltman93968@balladhealth.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN0000162518 | TN | |
| Family Nurse Practitioner | 363LF0000X | 23142 | TN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 23142 | TN | Yes |
Addresses
Primary practice location
109 W Watauga Ave
Johnson City, TN 37604-5668
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565
Other practice location 1
701 Med Tech Pkwy Ste 201
Johnson City, TN 37604-2365
Phone (423) 283-7302
Other practice location 2
525 N State Of Franklin Rd Ste 9
Johnson City, TN 37604-8213
Phone (423) 302-3480
Other practice location 3
701 Med Tech Pkwy Ste 200
Johnson City, TN 37604-2371
Phone (423) 283-7302
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jaltman93968@balladhealth.medalliesdirect.net | Direct | Wellmont Medical Associates Inc |
Other providers in Johnson City, TN
- Melony April Almany
- Kayla O Almanzor
- Tammy Kim Almond
- Sergio Gabriel Alonso
- Hamza Manaf Mahmoud Altal
- J. Michael Amburgey
- American Toxicology Lab, LLC
- Zachary Glen Ames
- Mohammad Bin Amir
- Rachel Jarratt Amodei
All providers in Johnson City, TN · Psychiatric/Mental Health Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.