DR. JASON GLEN FUNDERBURK MD
NPI 1104883966
Radiology - Vascular & Interventional Radiology in Knoxville, TN
About Dr. Jason Glen Funderburk Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JASON GLEN FUNDERBURK MD (NPI 1104883966) is an individual vascular & interventional radiology provider in Knoxville, Tennessee, licensed in Tennessee (47153) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Great Falls Clinic Hospital, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1999).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jason Glen Funderburk Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jason Funderburk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Great Falls, MT 59405
- Reassigned Medicare billing, Montana enrollment
- 119 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Great Falls Clinic Hospital
Acute Care Hospitals · Great Falls, MTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 37934 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KNOXVILLE, TN 37934
KNOXVILLE, TN 37934
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jason Funderburk's NPI number?
The NPI number for Jason Funderburk is 1104883966. It was assigned to this individual provider in the NPPES registry on April 27, 2006.
Where is Jason Funderburk located?
Jason Funderburk practices at 116 Concord Rd Suite 500, Knoxville, TN 37934. The listed phone number is (865) 777-6880.
What is Jason Funderburk's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.
Is Jason Funderburk enrolled in Medicare?
Yes. Jason Funderburk is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jason Funderburk's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jason Funderburk reassigns Medicare benefits to Great Falls Clinic LLC (Great Falls, MT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jason Funderburk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jason Funderburk accept?
Health plans from Blue Cross and Blue Shield of Montana and Mountain Health CO-OP list Jason Funderburk as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Jason Funderburk affiliated with any hospitals?
According to CMS data, Jason Funderburk is affiliated with Great Falls Clinic Hospital.
When was this NPI record last updated?
The NPPES record for Jason Funderburk was last updated on April 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Jason Glen Funderburk, MD · NPI 1104883966
Vascular & Interventional Radiology physician in Knoxville, Tennessee. Individual provider, active in the CMS NPPES registry since April 27, 2006.
## Identity
- **NPI:** 1104883966 (Entity type: Individual)
- **Enumerated:** April 27, 2006
- **Primary specialty:** Radiology - Vascular & Interventional Radiology · taxonomy 2085R0204X
- **State license:** 47153 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 116 CONCORD RD, SUITE 500, Knoxville, TN 37934-2940
- **Phone:** (865) 777-6880
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Great Falls Clinic LLC (NPI 1801897780, Great Falls, MT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Louisiana State University School Of Medicine In New Orleans, class of 1999
## Record status
- **NPPES last updated:** April 9, 2014
---
Source: [NPI Profile](https://npiprofile.com/npi/1104883966) · Data from the CMS NPPES public registry.