Individual provider Active NPI

Kent Hjerpe, M.D.

  • Obstetrics & Gynecology Physician
  • Johnson City, TN
National Provider Identifier
1669477022
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
53695 Issued in TN
Practice address
325 N State of Franklin Rd
First Floor
Johnson City, TN 37604-6056
Phone
(423) 439-7272
Fax
(423) 439-7235
NPI assigned
Jun 14, 2005
Last updated
May 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 38757 KY
Obstetrics & Gynecology Physician 207V00000X 53695 TN Primary

Addresses

Primary practice location

325 N State of Franklin Rd
First Floor
Johnson City, TN 37604-6056

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6039

Other identifiers 2

IdentifierTypeStateIssuer
64087786MedicaidKY
3714470OtherTNGROUP MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160308001292 TN Practitioner - Obstetrics/Gynecology 7416932587 Reassigns benefits to 1 organization
I20201109003048 TX Practitioner - Obstetrics/Gynecology 7416932587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
53695TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Oct 13, 2020 Accepting new patients
Medical Education Assistance Corporation Obstetrics & Gynecology CurrentSince Feb 2, 2016 Accepting new patients

Locations

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

325 N State of Franklin Rd
Fl 1
Johnson City, TN 37604
Phone (423) 439-7272

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1669477022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "address_2": "FIRST FLOOR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046056",
            "telephone_number": "423-439-7272",
            "fax_number": "423-439-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HJERPE",
        "first_name": "KENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "38757",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "53695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64087786",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3714470",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.