Jared Todd Gremillion, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

857 Issued in TN

Practice address

240 Medical Park Blvd Ste 1500
Bristol, TN 37620-7353

Phone

(423) 990-2460

NPI assigned

May 20, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaredgremillion@hmgpath.allscriptsdirect.net

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.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation
• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1639526577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2093",
            "fax_number": "423-390-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MEDICAL PARK BLVD STE 1500",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207353",
            "telephone_number": "423-990-2460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Imperial Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706055362",
            "country_code": "US",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREMILLION",
        "first_name": "JARED",
        "middle_name": "TODD",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-20",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "POD.INTERN",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Allen Green, HEALTH EDUCATOR
• Amy Lynn Greene, MA
• Morgan Gilmer Greene, DO
• Thomas C Greene, M.D.
• Jamie Beavers Greeson, MS, LPC
• Stefan J Grenvik, MD
• Douglas H Grier, MD
• Jennifer Lee Griffin, FNP
• Lori R Griffin, PHARMD
• John G. Griffith, M.D.

• Podiatrist in Bristol, TN
• Providers in Bristol, TN by specialty
• Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.