Johnna Kaye Yealy, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1377 Issued in TN

Practice address

930 Madison Ave
Suite 890
Memphis, TN 38103-3410

Phone

(901) 866-8834

Fax

(901) 302-2834

NPI assigned

Aug 31, 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 identifiers 1

Other names 1

• Johnna Tanner Former name

Medicare fee-for-service enrollment

Enrolled in TN, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

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

Locations

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.

• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884

  Physician Assistant

  Medicare reassignment NPD
• Ut Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Memphis, TN
  • NPI 1780676650

  Physician Assistant

  Medicare reassignment NPD
• Ut Medical Group, Inc.

  • Ophthalmology Physician
  • Memphis, TN
  • NPI 1326919200
  NPD
• Utmg Dermatopathology, LLC

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1922343623
  NPD (past)
• J David Outland, M.D.

  • Dermatology Physician
  • Murray, KY
  • NPI 1629243860
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1871604488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2157 IDLEWOOD CV",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381395316",
            "telephone_number": "615-970-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MADISON AVE",
            "address_2": "SUITE 890",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033410",
            "telephone_number": "901-866-8834",
            "fax_number": "901-302-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEALY",
        "first_name": "JOHNNA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC 015",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN STATE LICENSE",
            "identifier": "PA1377",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNA",
            "last_name": "TANNER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Andrew Yaun, M.D.
• Robert James Yawn, M.D.
• Noelle Ybos, PA-C
• Cheng Ye, PHARM D
• Stella Ying Ye, PHARMD
• Katherine Yeatman
• Neeraja Yedlapati, MD
• Andrea Win-Lim Yee, O.D.
• Nabeel Tahseen Yehyawi, PSY.D.
• Jill Yelland

• Physician Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.