Fereshteh Gerayli, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39001 Issued in TN

Practice address

917 W Walnut St
Johnson City, TN 37604

Phone

(423) 439-6464

Fax

(423) 439-7118

NPI assigned

Dec 22, 2005

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

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

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Education Assistance Corporation

  dba ETSU Physicians and Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1861478661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 699",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERAYLI",
        "first_name": "FERESHTEH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "39001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• John Scott Gentry, O.D.
• Retha D Gentry, DNP
• Kelsey George, MS CF SLP
• Stephen A. Geraci, M.D.
• Elena Gertsen, M.D., PH.D.
• Kennedy Lee Gibbs, MEDICAL STUDENT MD
• Andrew Lee Gibson, MD
• Brian Scott Gibson, C.R.N.A.
• Brooke Gibson

• Family Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.