Individual provider Active NPI

Jason Michael Kiernan, NP, PHD

  • Acute Care Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1972605715
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
41041 Issued in TN
Practice address
200 New York Ave
Oak Ridge, TN 37830-5212
Phone
(865) 835-5400
NPI assigned
Sep 2, 2006
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704210566 MI
Acute Care Nurse Practitioner 363LA2100X 41041 TN Primary
Registered Nurse 163W00000X 4704210566 MI

Addresses

Primary practice location

200 New York Ave
Oak Ridge, TN 37830-5212

Mailing address

200 New York Ave Ste 200
Oak Ridge, TN 37830-5225
Phone (865) 835-5400

Other identifiers 1

IdentifierTypeStateIssuer
Q112378MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kiernan.jason.michael@covenanthealth.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 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

Enrollment IDStateProvider typePAC IDDetails
I20071019000394 MI Practitioner - Nurse Practitioner 8123114253 Reassigns benefits to 2 organizations
I20260429003517 TN Practitioner - Nurse Practitioner 8123114253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

3003 W Grand River Ave
Howell, MI 48843-8539
Phone (517) 546-4210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4704210566MIMDNurse Practitioner
41041TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Nurse Practitioner CurrentSince Jan 6, 2026 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Apr 5, 2025 Accepting new patients
Thompson Oncology Group CurrentSince Apr 20, 2026 Accepting new patients
Cumberland Oncology & Hematology PastSince Apr 20, 2026 Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

400 Renaissance Ctr
Ste 2600
Detroit, MI 48243
Phone (248) 599-1582

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

3003 W Grand River Ave
Howell, MI 48843
Phone (517) 323-9133

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

200 New York Ave
Oak Ridge, TN 37830
Phone (865) 483-7511

200 New York Ave
Ste 200
Oak Ridge, TN 37830
Phone (865) 331-1720

Interoperability endpoints

  • Direct secure messaging: kiernan.jason.michael@covenanthealth.cernerdirect.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1972605715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 200",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305225",
            "telephone_number": "865-835-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305212",
            "telephone_number": "865-835-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704210566",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "41041",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704210566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q112378",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kiernan.jason.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 New York Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378305212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.