DR. JERRY DON WALKUP JR. (NPI# 1578856985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578856985 |
| Entity Type | Individual |
| Full Name | DR. JERRY DON WALKUP JR. |
| Credential | M.D. |
| Practice Address |
2312 Knob Creek Rd Ste 208 Johnson City TN 37604-2367 |
| Practice Telephone | (423) 610-1099 |
| Mailing Telephone | (423) 610-1099 |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2017-07-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
0101256238 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
2312 KNOB CREEK RD STE 208 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720641137 | Brooke Nicole Griffith | Nurse Practitioner | 2312 Knob Creek Rd Ste 208, Johnson City, TN 37604-2367 | 2019-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376533489 | Ashish B Madhok | Pediatrics | 2312 Knob Creek Rd, Suite208, Johnson City, TN 37604-2367 | 2005-10-28 |
| 1679842637 | Medical Education Assistance Corporation | Pediatrics | 325 N State of Franklin Rd, Johnson City, TN 37604 | 2011-12-21 |
| 1841362555 | Tri-city Pediactric Cardiology P C | Pediatrics | 2312 Knob Creek Rd, Suite 208, Johnson City, TN 37604-2367 | 2006-11-15 |
| 1477515880 | Ashok V Mehta | Pediatrics | 2312 Knob Creek Rd, Ste 208, Johnson City, TN 37604-2367 | 2006-04-03 |
| 1821081134 | Rajani Anand | Pediatrics | 325 N State of Franklin Rd, Ground Floor, Johnson City, TN 37604-6062 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851766760 | Jami Shakibi | Pediatrics | 812 Cobble Cv, Nashville, TN 37211-7934 | 2015-12-03 |
| 1275970048 | Benjamin Acheampong | Pediatrics | 3601, Nashville, TN 37232-0001 | 2013-06-03 |
| 1053758516 | Nicole Kristen Perry | Pediatrics | 330 23rd Ave N Ste 550, Nashville, TN 37203-1706 | 2013-05-23 |
| 1003992686 | Nisha K Surenderanath | Pediatrics | 2100 Clinch Ave Ste 420, Knoxville, TN 37916-2231 | 2006-10-27 |
| 1740216514 | Nancy Ann Chase | Pediatrics | 805 Estate Pl Ste 1, Memphis, TN 38120-0647 | 2006-06-24 |
| 1194772178 | Gerald Johnson | Pediatrics | 6148 Lee Hwy Ste 206, Chattanooga, TN 37421 | 2006-05-27 |
| 1679560288 | James K Stamps | Pediatrics | 80 Humphreys Center, Suite 230, Memphis, TN 38120 | 2005-09-29 |
| 1548255276 | Fred S Lamb | Pediatrics | 5111 Dot, 2200 Childrens Way, Nashville, TN 37232-0001 | 2005-09-19 |
| 1679126056 | Knoxville Pediatric Cardiology Morristown | Pediatrics | 1817 W Morris Blvd, Morristown, TN 37813-2837 | 2019-07-24 |
| 1316459829 | Gerald E Johnson Md Pllc | Pediatrics | 6148 Lee Hwy Ste 206, Chattanooga, TN 37421-6515 | 2017-10-25 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.