Jae Gyun Maeng, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

73979 Issued in TN

Practice address

9017 Cross Park Dr Ste 200
Knoxville, TN 37923-8605

Phone

(865) 690-1161

Fax

(865) 381-1509

NPI assigned

Mar 28, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Knoxville Pediatric Associates, P.C.

  • Pediatrics Physician
  • Knoxville, TN
  • NPI 1407946312

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1881344349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9017 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379238605",
            "telephone_number": "865-690-1161",
            "fax_number": "865-381-1509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Clinch Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379162203",
            "country_code": "US",
            "telephone_number": "865-525-0228",
            "fax_number": "865-381-1509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAENG",
        "first_name": "JAE",
        "middle_name": "GYUN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "73979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Dalton Madigan, MD
• Luke Madigan, MD
• Marissa Madigan, DNP, RN, FNP-BC
• Michael Patrick Madigan, D.M.D
• Robert R. Madigan, M.D.
• Amye L Maffei, L.C.S.W
• Patricia Anne Maffeo, PH D
• Michael L Maggart, M.D.
• Joseph Henry Maginn, OT
• Luke Maglich, MD

• Pediatrics Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.