Active NPI
Jerod William Bachman, DO
- Student in an Organized Health Care Education/Training Program
- Abingdon, VA
National Provider Identifier
1679133540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 16000 Johnston Memorial Dr
Abingdon, VA 24211-7664 - Phone
- (276) 258-4435
- NPI assigned
- Jun 13, 2019
- Last updated
- Jun 13, 2019
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Mailing address
1409 Lamar CT
Kingsport, TN 37664-2057
Phone (423) 956-2934
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1679133540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 LAMAR CT",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376642057",
"telephone_number": "423-956-2934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16000 JOHNSTON MEMORIAL DR",
"city": "ABINGDON",
"state": "VA",
"postal_code": "242117664",
"telephone_number": "276-258-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACHMAN",
"first_name": "JEROD",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Abingdon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.