Individual provider Active NPI

Jeremy Vincent Pinyard, M.D.

  • Internal Medicine Physician
  • Johnson City, TN
National Provider Identifier
1689933301
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
52905 Issued in TN
Practice address
516 W Oakland Ave
Suite 106
Johnson City, TN 37604-1676
Phone
(423) 722-3100
Fax
(423) 722-3104
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 25MA09155600 NJ
Internal Medicine Physician 207R00000X 52905 TN Primary
Hospitalist Physician 208M00000X 41900 IA

Addresses

Primary practice location

516 W Oakland Ave
Suite 106
Johnson City, TN 37604-1676

Mailing address

516 W Oakland Ave
Suite 106
Johnson City, TN 37604-1676
Phone (423) 722-3100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160108002270 TN Practitioner - Internal Medicine 8628227071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2839 Hwy 231 N
Suite 101
Shelbyville, TN 37160-7448
Phone (931) 488-4014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41900IAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Recovery Center of Middle Tennessee, LLC CurrentSince Apr 2, 2024 Accepting new patients
Cedar Recovery of Middle Tennessee, LLC CurrentSince Apr 2, 2024 Accepting new patients

Locations

2636 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 680-0110

5000 Crossings Cir
Ste 103
Mt Juliet, TN 37122
Phone (615) 208-9549

2839 Highway 231 N
Ste 101
Shelbyville, TN 37160
Phone (931) 488-4014

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1689933301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 W OAKLAND AVE",
            "address_2": "SUITE 106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041676",
            "telephone_number": "423-722-3100",
            "fax_number": "423-722-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W OAKLAND AVE",
            "address_2": "SUITE 106",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041676",
            "telephone_number": "423-722-3100",
            "fax_number": "423-722-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINYARD",
        "first_name": "JEREMY",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09155600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52905",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "41900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.