Jahn Osvaldo Acevedo-Ortiz, MD
Individual provider Active NPI Family Medicine Physician · South Fulton, TN
NPI 1841936739 · NPPES record last updated Aug 4, 2026
Key facts
- NPI
- 1841936739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- AJ1165667-237 (TN)
- Practice address
- 1135 Broadway St
South Fulton, TN 38257-2835 - Phone
- (731) 479-2606
- NPI assigned
- May 12, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230807000281 | TN | Order and Referring Only - Family Practice |
4981065075 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AJ1165667-237 | TN | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AJ1165667-237 | TN | Yes |
Addresses
Primary practice location
1135 Broadway St
South Fulton, TN 38257-2835
Mailing address
257 Bancorp South Pkwy
Jackson, TN 38305-7582
Phone (731) 479-2606
NPI Registry JSON
{
"created_epoch": "1652313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1841936739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 BANCORP SOUTH PKWY",
"city": "JACKSON",
"state": "TN",
"postal_code": "383057582",
"telephone_number": "731-479-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 BROADWAY ST",
"city": "SOUTH FULTON",
"state": "TN",
"postal_code": "382572835",
"telephone_number": "731-479-2606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACEVEDO-ORTIZ",
"first_name": "JAHN",
"middle_name": "OSVALDO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-12",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "AJ1165667-237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Fulton, TN
- Philip Andrews
- At Home Outpatient Physical Therapy LLC
- Elaine Leslie Barnes
- Robin A Chappell
- Clement Medical, PLLC
All providers in South Fulton, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.