Active NPI
Jessica Leane Smith Johnson, PA-C
- Physician Assistant
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6555
- Practice address
- 2202 N John B Dennis Hwy Ste 204
Kingsport, TN 37660-5904 - Phone
- (423) 245-1040
- NPI assigned
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 6555 | TN | |
| Physician Assistant | 363A00000X | 6555 | TN | Primary |
Addresses
Primary practice location
2202 N John B Dennis Hwy Ste 204
Kingsport, TN 37660-5904
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111
Other names 1
- Jessica Smith
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2202 N John B Dennis Hwy
Suite 204
Kingsport, TN 37660-5904
Phone (423) 245-1040
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6555 | TN | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WPS Providers Inc | Current | Accepting new patients |
Locations
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
2202 N John B Dennis Hwy
Ste 204
Kingsport, TN 37660
Phone (423) 224-3300
Organizations & group practices 1
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.
-
- General Practice Physician
- Kingsport, TN
- NPI 1003904095
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1992813240
-
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1699354415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-952-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2202 N JOHN B DENNIS HWY STE 204",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376605904",
"telephone_number": "423-245-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JESSICA",
"middle_name": "LEANE SMITH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-07",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TN",
"license": "6555",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "6555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "SMITH",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.