Jeffrey R Merrill, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD30902 Issued in TN

Practice address

1019 W Oakland Ave
Suite 1
Johnson City, TN 37604-2357

Phone

(423) 915-5000

Fax

(423) 915-5045

NPI assigned

Apr 26, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

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

State licenses

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.

• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Internal Medicine Physician
  • Marion, VA
  • NPI 1124438627
  NPD

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1669438784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3700",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023700",
            "telephone_number": "423-952-2122",
            "fax_number": "423-952-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W OAKLAND AVE",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042357",
            "telephone_number": "423-915-5000",
            "fax_number": "423-915-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD30902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669438784",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3858149",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carialee Mermilliod
• Raymond Daniel Merrick, MD
• Angela S Merrifield, MD
• David L Merrifield Jr., MD
• Cheryl V Merriken, LMT
• Carolyn S. Merriman, FNP
• Suzanne Kennerly Merritt, COTA/L
• Krystal Starr Merz, LPN
• Messiah Transportation
• Samuel F Messimer, DC

• Family Medicine Physician in Johnson City, TN
• Providers in Johnson City, 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 Jun 22, 2015; 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.