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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

HOLLY RENEE NUMMERDOR DO
NPI 1114504545
Family Medicine in Johnson City, TN

Active since March 24, 2021PECOS Enrolled
701 MED TECH PKWY STE 401, JOHNSON CITY, TN 37604(423) 631-0646(423) 631-0647 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2026, Feb 4, 2026, Feb 18, 2025 and 2 more (5 updates tracked since 2021).

About Holly Renee Nummerdor Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY RENEE NUMMERDOR DO (NPI 1114504545) is an individual family medicine provider in Johnson City, Tennessee, licensed in Tennessee (5826) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Wellmont Holston Valley Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1114504545
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameHOLLY RENEE NUMMERDORCredential: DO
Location Address701 MED TECH PKWY STE 401Johnson City, TN 37604-2372
Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 952-2111
Phone(423) 631-0646
Fax(423) 631-0647
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 24, 2021
Last NPPES UpdateJuly 28, 20265 updates tracked since enumeration
NPPES CertifiedJuly 28, 2026
✔ NPI 1114504545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · 5826
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
701 MED TECH PKWY STE 401, Johnson City, TN 37604
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11497 W Elk Ave Ste 21Elizabethton, TN 37643-2896 · Phone (423) 542-7420
Location 21242 W Shipley Ferry RdKingsport, TN 37663-3323 · Phone (423) 239-7300 · Fax (423) 239-7607
Location 3102 E Ravine RdKingsport, TN 37660-3814 · Phone (920) 210-5194

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly Renee Nummerdor Do 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.

PECOS PAC ID840691549
PECOS Enrollment IDI20240726002555
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
106 services72 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
83 services65 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
76 services63 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
44 services42 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
39 services38 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test 85027
A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
30 services28 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440017
Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County
Emergency services

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440063
Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County
Emergency services Birthing friendly

Indian Path Community Hospital

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440176
Location2000 Brookside DrKingsport, TN 37660 · Sullivan County
Emergency services Birthing friendly

Franklin Woods Community Hospital

Acute Care Hospitals · Johnson City, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440184
Location300 Med Tech ParkwayJohnson City, TN 37604 · Washington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAUL C LANGE MD
Hospitalist
701 MED TECH PKWY STE 401
JOHNSON CITY, TN 37604
Washington County (423) 631-0646
MRS. REKHA KADAM FNP
Nurse Practitioner (Family)
701 MED TECH PKWY STE 401
JOHNSON CITY, TN 37604
Washington County (423) 631-0646

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 Holly Nummerdor's NPI number?

The NPI number for Holly Nummerdor is 1114504545. It was assigned to this individual provider in the NPPES registry on March 24, 2021.

Where is Holly Nummerdor located?

Holly Nummerdor practices at 701 Med Tech Pkwy Ste 401, Johnson City, TN 37604. The listed phone number is (423) 631-0646.

What is Holly Nummerdor's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Holly Nummerdor enrolled in Medicare?

Yes. Holly Nummerdor 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.

What insurance does Holly Nummerdor accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Holly Nummerdor 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 Holly Nummerdor affiliated with any hospitals?

According to CMS data, Holly Nummerdor is affiliated with Wellmont Holston Valley Medical Center, Johnson City Medical Center, Indian Path Community Hospital and Franklin Woods Community Hospital.

When was this NPI record last updated?

The NPPES record for Holly Nummerdor was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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.