Jayne Lyn O'Gorman, PA-C

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

200 New York Ave Ste 150
Oak Ridge, TN 37830-5227

Phone

(865) 835-5855

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jayne Johnson Former name

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jayne.o.gorman.1@25843.direct.athenahealth.com

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.

• Family Residences and Essential Enterprises, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Old Bethpage, NY
  • NPI 1497943757
  NPD (past)
• Maddox Parkway Inpatient Services, LLC

  • Nurse Practitioner
  • Chatsworth, GA
  • NPI 1144569914
  NPD (past)
• Skills Unlimited, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oakdale, NY
  • NPI 1487789392
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1851400428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 E 77th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751912",
            "country_code": "US",
            "telephone_number": "646-687-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'GORMAN",
        "first_name": "JAYNE",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007576-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYNE",
            "last_name": "JOHNSON",
            "credential": "MD, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Oak Ridge Chiropractic
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• Student in an Organized Health Care Education/Training Program in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.