Jason D Pickup, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

9613 Issued in TN

Practice address

117 W Sevier Ave
Suite 220
Kingsport, TN 37660-3799

Phone

(423) 224-3200

Fax

(423) 224-3208

NPI assigned

Apr 7, 2009

Last updated

Aug 13, 2013By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1710120761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3200",
            "fax_number": "423-224-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3200",
            "fax_number": "423-224-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKUP",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "9613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532052",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Lynn Phillips-Brown, PHARMD/MPH
• Carl Dean Phillips II
• James C. Phillips, M.D.
• Kathy Melinda Phillips, LMSW
• Lindsy Philllips
• Allison Pierce, M.D.
• Daryl Wayne Pierce, MD
• Kristin Pierce, M.D.
• Octavio J Pinell, MD
• Gina M Pinney, R. PH.

• Oral and Maxillofacial Surgery (Dentist) in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.