Active NPI
Paden John Vernon, MD
- Emergency Medicine Physician
- Greenville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2026-02640
- Practice address
- 2100 Stantonsburg Rd
Greenville, NC 27834-2818 - Phone
- (252) 744-4757
- Fax
- (252) 744-5014
- NPI assigned
- Apr 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2026-02640 | NC | Primary |
| Emergency Medicine Physician | 207P00000X | 60451 | KY | |
| Emergency Medicine Physician | 207P00000X | MMD.87636 | SC |
Addresses
Primary practice location
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other practice location 1
250 Park St
Bowling Green, KY 42101-1760
Phone (270) 745-1000
Other practice location 2
169 Ashley Ave
Charleston, SC 29425-8905
Phone (843) 792-2575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
250 Park St
Bowling Green, KY 42101-1795
Phone (270) 745-1000
Hospital & facility affiliations
- The Medical Center (Bowling Green)
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MMD.87636 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
Locations
250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254
Organizations & group practices 1
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 Physician
- Maysville, KY
- NPI 1356379382
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bowling Green, KY
- NPI 1043293608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1902541014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342818",
"telephone_number": "252-744-4757",
"fax_number": "252-744-5014"
}
],
"practiceLocations": [
{
"address_1": "250 Park St",
"address_purpose": "LOCATION",
"city": "Bowling Green",
"state": "KY",
"postal_code": "421011760",
"country_code": "US",
"telephone_number": "270-745-1000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "169 Ashley Ave",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294258905",
"country_code": "US",
"telephone_number": "843-792-2575",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"replacement_npi": "1902541014",
"last_name": "VERNON",
"first_name": "PADEN",
"middle_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-30",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2026-02640",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "60451",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "MMD.87636",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.