Walter John Jermakowicz, M.D., PH.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

58744 Issued in TN

Practice address

105 S Willow Ave
Cookeville, TN 38501-4667

Phone

(931) 372-7716

Fax

(931) 372-7717

NPI assigned

Jun 7, 2012

Last updated

Apr 12, 2022By the provider in NPPES

Sex

Male

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 2

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Neurosurgery

Education

Vanderbilt University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Livingston, TN, CCN 447260
• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009
• Livingston Regional Hospital Hospital, Livingston, TN, CCN 440187

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
• Direct secure messaging: walter.jermakowicz.1@1366.direct.athenahealth.com

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.

• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141

  Neurological Surgery

  Medicare reassignment Care Compare group NPD
• Living Life Services Inc .

  • Clinic/Center
  • Haines City, FL
  • NPI 1255157699
  Medicare reassignment NPD Authorized official
• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  Medicare reassignment NPD
• Campbell Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Carthage, TN
  • NPI 1669366068
  NPD
• Campbell Clinic

  dba Campbell Clinic MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Germantown, TN
  • NPI 1588619944
  NPD (past)
• WB Health Care Services, Inc.

  • Home Health Agency
  • Doral, FL
  • NPI 1477867695
  NPD (past)

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

• Comprehensive Home Healthcare Services LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Livingston, TN
  • NPI 1972551752
  Care Compare affiliation
• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation
• Cumberland Medical Center, Inc.

  dba Cumberland Medical Center

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403
  Care Compare affiliation
• Livingston Regional Hospital LLC

  dba Livingston Regional Hospital

  • Rural Acute Care Hospital
  • Livingston, TN
  • NPI 1396760542
  Care Compare affiliation

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1922369750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014667",
            "telephone_number": "931-372-7716",
            "fax_number": "931-372-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014667",
            "telephone_number": "931-372-7716",
            "fax_number": "931-372-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERMAKOWICZ",
        "first_name": "WALTER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "58744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE MEDICAL LICENSE",
            "identifier": "58744",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q054619",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjestus@t1ortho.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 S Willow Ave",
            "city": "Cookeville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385014667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bonnie Beth Jenkins, M.S., R.D., L.D.
• Haley Paige Jenkins
• Thomas A Jenkins, MD
• Oniah Jensen, RBT
• Jeremy Robinson DDS PLLC (Robinson DentalCare)
• Joseph A Jestus, M.D.
• Melinda Jane Jetter, R.N.
• Deborah Jiang, M.D.
• Maria Guadalupe Jimenez, LPN
• John B. Averitt, PH.D., Licensed Psychologist

• Neurological Surgery Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.

Verify at the official NPI Registry.