Individual provider Active NPI

John J Sillery, D.O.

  • Emergency Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1992914105
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO2047 Issued in TN
Practice address
2525 Desales Avenue
Chattanooga, TN 37404
Phone
(423) 697-0014
Fax
(423) 648-6280
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0065121 MD
Emergency Medicine Physician 207P00000X OS014183 PA
Emergency Medicine Physician 207P00000X DO2047 TN Primary

Addresses

Primary practice location

2525 Desales Avenue
Chattanooga, TN 37404

Mailing address

725 Glenwood Drive,
Suite E-487
Chattanooga, TN 37404
Phone (423) 697-0014

Other identifiers 1

IdentifierTypeStateIssuer
1514496MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NM2 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

Enrollment IDStateProvider typePAC IDDetails
I20090730000289 TN Practitioner - Emergency Medicine 7911050463 Reassigns benefits to 2 organizations
I20120921000601 NM Practitioner - Emergency Medicine 7911050463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0065121MDMDEmergency Medicine Physician
OS014183PAMDEmergency Medicine Physician
DO2047TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee River Physicians, PLLC Emergency Medicine CurrentSince Aug 20, 2017 Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine CurrentSince Aug 20, 2017 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 5, 2015 Accepting new patients
Tennessee River Physicians, PLLC Emergency Medicine Current Accepting new patients
Fedko Emergency Physicians New Mexico LLC Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Chattanooga Emergency Medicine PLLC PastSince Mar 20, 2022 Accepting new patients
Jellico Emergency Physicians Medical Group PC Emergency Medicine Past Accepting new patients
Chattanooga Emergency Medicine PLLC PastSince Mar 20, 2022 Accepting new patients
Jemez Mountain Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1016 E Roosevelt Ave
Grants, NM 87020
Phone (505) 287-4446

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

188 Hospital Ln
Jellico, TN 37762
Phone (423) 784-1272

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

726 McFarland St
Morristown, TN 37814
Phone (423) 522-6160

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1992914105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DRIVE,",
            "address_2": "SUITE E-487",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVENUE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-697-0014",
            "fax_number": "423-648-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLERY",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0065121",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS014183",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "DO2047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514496",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.