Active NPI
Jefferey Robert Jernigan, M.D.
- Anesthesiology Physician
- Johnson City, TN
National Provider Identifier
1801857487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD0000018525
- Practice address
- 1009 Novus Dr Ste 2
Johnson City, TN 37604-8237 - Phone
- (423) 283-0776
- NPI assigned
- Mar 31, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD0000018525 | TN | Primary |
Addresses
Primary practice location
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Mailing address
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776
Other practice location 1
8901 Wisconsin Ave.
Anesthesia Dept./NNMC
Bethesda, MD 20889-0001
Phone (301) 295-4455 ext. 157
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000018525 | TN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ut Medical Group Inc | Past | Accepting new patients | |
| Ut Medical Group, Inc. | Past | Accepting new patients |
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.
-
- Multi-Specialty Clinic/Center
- Memphis, TN
- NPI 1780676650
-
- Ophthalmology Physician
- Memphis, TN
- NPI 1326919200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1801857487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 NOVUS DR STE 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048237",
"telephone_number": "423-283-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 NOVUS DR STE 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048237",
"telephone_number": "423-283-0776"
}
],
"practiceLocations": [
{
"address_1": "8901 Wisconsin Ave.",
"address_2": "Anesthesia Dept./NNMC",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "208890001",
"country_code": "US",
"telephone_number": "301-295-4455 x157",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JERNIGAN",
"first_name": "JEFFEREY",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TN",
"license": "MD0000018525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.