DR. JEFFORY GLENN JENNINGS (NPI# 1598744336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598744336 |
| Entity Type | Individual |
| Full Name | DR. JEFFORY GLENN JENNINGS |
| Credential | MD |
| Practice Address |
2100 W Clinch Ave Koppel Plaza, Ste 420 Knoxville TN 37916-2219 |
| Mailing Address |
Po Box 15004 Knoxville TN 37901 |
| Practice Telephone | 8655220420 |
| Practice Fax Number | 8655229068 |
| Mailing Telephone | 8655229730 |
| Mailing Fax Number | 8656372520 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2014-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
014885 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1510582 | 05 | |
| TN | BCBS | 4188709 | 01 |
| Street Address |
2100 W CLINCH AVE KOPPEL PLAZA, STE 420 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37916-2219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215922547 | Clarisa E Cuevas | Specialist | 2100 W Clinch Ave, Suite 510, Knoxville, TN 37916-2219 | 2005-09-13 |
| 1346718020 | Lauri Michelle Gingerich | Nurse Practitioner | 2100 W Clinch Ave, Knoxville, TN 37916-2219 | 2018-11-11 |
| 1841738275 | Christy Michelle Howard | Nurse Practitioner | 2100 W Clinch Ave, Suite 330, Knoxville, TN 37916-2219 | 2017-02-06 |
| 1215392030 | Gi for Kids, Pllc | Pediatrics | 2100 W Clinch Ave, Ste 510, Knoxville, TN 37916-2219 | 2015-12-21 |
| 1396114583 | Misty E Murphy | Nurse Practitioner | 2100 W Clinch Ave, # 510, Knoxville, TN 37916-2219 | 2015-09-18 |
| 1811300379 | Amanda Harper | Nurse Practitioner | 2100 W Clinch Ave, Knoxville, TN 37916-2219 | 2014-06-03 |
| 1154731917 | Pediatric Ear, Nose & Throat Associates, P.C. | Nurse Practitioner | 2100 W Clinch Ave, Ste 330, Knoxville, TN 37916-2219 | 2014-05-02 |
| 1730521667 | Danielle L Gosser | Physician Assistant | 2100 W Clinch Ave, 120, Knoxville, TN 37916-2288 | 2013-07-19 |
| 1831449800 | Callie M Jubran | Dietitian, Registered | 2100 W Clinch Ave, #510, Knoxville, TN 37916-2219 | 2012-09-17 |
| 1497005466 | Ashley N Treadway | Dietitian, Registered | 2100 W Clinch Ave, #510, Knoxville, TN 37916-2219 | 2012-09-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151322 | Chelsea Raye Tanner | Registered Nurse | American Anesthesiology of Tennessee, 501 20th Street, Suite 606, Knoxville, TN 37916 | 2020-10-13 |
| 1003473372 | Mary Katrina Quist Rouse | Nurse Practitioner | 2100 Clinch Ave Ste 330, Knoxville, TN 37916 | 2019-05-22 |
| 1457881724 | Leslie Lynette Taylor | Physical Medicine & Rehabilitation | 2120 Highland Avenue, Knoxville, TN 37916 | 2017-06-19 |
| 1235547423 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 2429 University Commons Way, Knoxville, TN 37916 | 2014-07-31 |
| 1801182340 | Jessica Lee Sheah | Psychiatry & Neurology | 2100 W Clinch Avenue, Suite 210, Knoxville, TN 37916 | 2011-06-23 |
| 1326203548 | Bradley Jason Davis | Internal Medicine | 1819 Clinch Ave Ste 114, Knoxville, TN 37916 | 2008-07-28 |
| 1003012782 | East Tennessee Children's Hospital Association, Inc | Clinic/Center | 2100 West Clinch Avenue, Suite 510, Knoxville, TN 37916 | 2007-06-21 |
| 1922203108 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 611 22nd Street, Knoxville, TN 37916 | 2007-06-18 |
| 1699825984 | Orthodontic Design By Michael Sawaf | Dentist | 2220 White Ave, Knoxville, TN 37916 | 2007-01-11 |
| 1427115096 | Deborah Lynne Maples | Physical Therapy Assistant | Nhc Ft Sanders 2120 Highland Ave, Knoxville, TN 37916 | 2007-01-03 |
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| 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 |
|---|---|---|---|---|
| 1003992686 | Nisha K Surenderanath | Pediatrics | 2100 Clinch Ave Ste 420, Knoxville, TN 37916-2231 | 2006-10-27 |
| 1265666747 | East Tennessee Pediatric Cardiology, P.C. | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2009-05-12 |
| 1013091123 | Michael R Liske | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2006-10-25 |
| 1124072095 | Sumeet K. Sharma | Pediatrics | 2100 W Clinch Ave, Koppel Plaza, Ste 420, Knoxville, TN 37916-2219 | 2006-05-22 |
| 1356320311 | Yvonne A Bremer | Pediatrics | 2001 Laurel Ave, Suite Ng4, Knoxville, TN 37916-1810 | 2006-01-10 |
| 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 |
| 1578856985 | Jerry Don Walkup Jr. | Pediatrics | 2312 Knob Creek Rd Ste 208, Johnson City, TN 37604-2367 | 2011-05-17 |
| 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 |
| 1376533489 | Ashish B Madhok | Pediatrics | 2312 Knob Creek Rd, Suite208, Johnson City, TN 37604-2367 | 2005-10-28 |
| 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 |
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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.