| NPI | 1164473005 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-05-15 |
| Last Updated | 2025-04-29 |
| Mailing Address | 1301 Sunset Dr, Ste 3 Johnson City, TN 37604-7906 United States Phone: (423) 926-4966 | Fax: (423) 926-1823 📍 View Map |
| Primary Practice Address | 1301 Sunset Dr, Ste 3 Johnson City, TN 37604-7906 United States Phone: (423) 926-4966 | Fax: (423) 926-1823 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | TN | 100022659 | PHP TNCARE |
| Other (non-Medicare) | TN | 300086799 | RAILROAD MEDICARE |
| Other (non-Medicare) | TN | 3098340 | BCBS |
| MEDICAID | TN | 3828412 | - |
| Other (non-Medicare) | KY | 64305642 | KENTUCKY MEDICAID |
| Other (non-Medicare) | VI | 7222688 | VIRGINIA MEDICAID |
| Other (non-Medicare) | NC | 89063JH | NORTH CAROLINA MEDICAID |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2085R0202X – Radiology, Diagnostic Radiology | TN | 30603 |
| No | 2085R0202X – Radiology, Diagnostic Radiology | VA | 0101259949 |
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About NPI 1164473005
Perry Jernigan M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1164473005. The primary specialty listed is Radiology, Diagnostic Radiology. The provider is located in Johnson City, TN. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-05-15. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1164473005?
NPI 1164473005 belongs to Perry Jernigan M.D., a Radiology, Diagnostic Radiology in Johnson City, TN. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1164473005 active?
The current status of NPI 1164473005 in the NPPES registry is Active. The record was last updated on 2025-04-29.
What specialty is NPI 1164473005?
NPI 1164473005 is classified under the taxonomy Radiology, Diagnostic Radiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1164473005?
You can verify NPI 1164473005 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1164473005?
The primary practice address on file for NPI 1164473005 is 1301 Sunset Dr, Johnson City, TN 37604-7906. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1164473005 issued?
NPI 1164473005 was first issued (enumerated) on 2006-05-15. The NPPES record was last updated on 2025-04-29.
Practice Location Map
Perry Jernigan is located at 1301 Sunset Dr, Johnson City, TN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Perry Jernigan. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1164473005. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Radiology, Diagnostic Radiology | 30603 | TN |
| Radiology, Diagnostic Radiology | 0101259949 | VA |