NPIMap

Individual provider Active NPI

Jason R Vance, M.D.

  • Family Medicine Physician
  • Ooltewah, TN
National Provider Identifier
1912938234
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A60594 Issued in CA
Practice address
2137 Heavenly VW
Ooltewah, TN 37363-9488
Phone
(530) 966-5454
Fax
(530) 872-6653
NPI assigned
Jul 5, 2006
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A60594 CA Primary
Adult Medicine Physician 207QA0505X 65025 TN
Adult Medicine Physician 207QA0505X 44928 AL

Addresses

Primary practice location

2137 Heavenly VW
Ooltewah, TN 37363-9488

Mailing address

2137 Heavenly VW
Ooltewah, TN 37363-9488
Phone (530) 966-5454

Other identifiers 3

IdentifierTypeStateIssuer
44928OtherALAL LICENSE
65025OtherTNTN LICENSE
ZZZ01920ZOtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080520000918 CA Practitioner - Family Practice 6901813468 Reassigns benefits to 1 organization
I20220804003940 TN Practitioner - Family Practice 6901813468 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russellville Hospital Inc.Group PAC ID 3476878489, shared by 6 NPIs, 66 clinicians
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

15225 Hwy 43
Russellville, AL 35653-1969
Phone (256) 331-2700

482 Interstate Dr
Manchester, TN 37355-3109
Phone (931) 728-4718

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee Medical Group LLC CurrentSince Sep 1, 2022 Accepting new patients
Coffee Medical Group LLC CurrentSince Sep 1, 2022 Accepting new patients
Paradise Medical Group, Inc. Family Medicine CurrentSince Oct 1, 2001 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Dec 4, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Dec 4, 2024 Accepting new patients
Jason Vance MD a Medical Corporation Family Medicine CurrentSince Jun 7, 2026 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Dec 4, 2024 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince Dec 4, 2024 Accepting new patients
LP Monteagle LLC Past Accepting new patients
HH Health System - Lincoln Inc Past Accepting new patients
The Waters of Cheatham LLC Past Accepting new patients
Waters of Winchester LLC Past Accepting new patients
HH Health System Lincoln Inc Past Accepting new patients
The Waters of Smyrna LLC Past Accepting new patients

Locations

277 Cohasset Rd
Chico, CA 95926
Phone (530) 332-5170

6460 Pentz Rd
Ste A
Paradise, CA 95969
Phone (530) 228-7926

6460 Pentz Rd
Ste C
Paradise, CA 95969
Phone (530) 221-1312

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586

482 Interstate Dr
Manchester, TN 37355
Phone (931) 728-4718

919 Medical Park Dr
Mountain City, TN 37683
Phone (423) 727-7800

Interoperability endpoints

  • Direct secure messaging: jason.vance.1@10649.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Donalson Care CenterFayetteville, TN, CCN 445173 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1912938234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 HEAVENLY VW",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639488",
            "telephone_number": "530-966-5454",
            "fax_number": "530-872-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 HEAVENLY VW",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639488",
            "telephone_number": "530-966-5454",
            "fax_number": "530-872-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JASON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A60594",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TN",
            "license": "65025",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AL",
            "license": "44928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE",
            "identifier": "44928",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "65025",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ01920Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.