Jill W Wireman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

24447 Issued in TN

Practice address

151 Lake Harbor Dr
Gray, TN 37615-2972

Phone

(423) 956-3187

NPI assigned

Jun 15, 2005

Last updated

Aug 7, 2023By the provider in NPPES

Sex

Female

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 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

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.

• State of Franklin Healthcare Associates PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1063459410

  Pediatrics

  Medicare reassignment NPD
• State of Franklin Healthcare Associates PLLC

  • Clinical Medical Laboratory
  • Johnson City, TN
  • NPI 1841846136
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1689679987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 LAKE HARBOR DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152972",
            "telephone_number": "423-956-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 LAKE HARBOR DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152972",
            "telephone_number": "423-956-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIREMAN",
        "first_name": "JILL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "24447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076811",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arissa Brooke Vaughn, PHARMD
• Walgreen Co (Walgreens #11113)
• Wellmont Medical Associates, Inc. (Ballad Health Medical Associates)
• Angela Marie Williams, BS
• Heather Marie Wine, MSN, FNP-C
• Michael Anthony Wolf, O.D.
• Timothy Andy Wooten, DPT
• Jefferson Andrew Young

• Pediatrics Physician in Gray, TN
• Providers in Gray, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.