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BRYAN J PRUDHOMME MD
NPI 1528270816
Pediatrics in Johnson City, TN

Active since May 07, 2007PECOS Enrolled
301 MED TECH PKWY, STE. 180, JOHNSON CITY, TN 37604(423) 794-5540(423) 926-3187 Get Directions Write a Review

NPPES record last updated: February 21, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Feb 21, 2025, Jul 11, 2018, Feb 28, 2018 and 1 more (4 updates tracked since 2017).

About Bryan J Prudhomme Md NPPES

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

BRYAN J PRUDHOMME MD (NPI 1528270816) is an individual pediatrics provider in Johnson City, Tennessee, licensed in Tennessee (42204) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528270816
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameBRYAN J PRUDHOMMECredential: MD
Location Address301 MED TECH PKWY, STE. 180Johnson City, TN 37604
Mailing AddressPo Box 632476Cincinnati, OH 45263-2476 · (423) 794-5540 · Fax (423) 926-3187
Phone(423) 794-5540
Fax(423) 926-3187
Sole ProprietorNo
Enumeration DateMay 7, 2007
Last NPPES UpdateFebruary 21, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 21, 2025
✔ NPI 1528270816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TN · 42204
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
301 MED TECH PKWY, Johnson City, TN 37604
Open in Google Maps ↗

Other Identifiers 1

Medicaid3000368TN

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 (PECOS)

Bryan J Prudhomme Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 20

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

SHELLY J MCINTOSH FNP
Nurse Practitioner (Family)
301 MED TECH PKWY, SUITE 240
JOHNSON CITY, TN 37604
Washington County (423) 794-5520
ARIEL DENTON APN
Nurse Practitioner (Women's Health)
301 MED TECH PKWY, SUITE 200
JOHNSON CITY, TN 37604
Washington County (423) 794-1300
MICHAEL Z PEARSON MD
Internal Medicine
301 MED TECH PKWY, STE. 280
JOHNSON CITY, TN 37604
Washington County (423) 794-5550
TRACY ROMANS NP
Nurse Practitioner (Family)
301 MED TECH PKWY, SUITE 240
JOHNSON CITY, TN 37604
Washington County (423) 794-5888
MARK A WILLIAMS MD
Internal Medicine
301 MED TECH PKWY, STE 240
JOHNSON CITY, TN 37604
Washington County (423) 794-5520
BRIAN H DUNKELBERGER M.D.
Obstetrics & Gynecology
301 MED TECH PKWY, STE. 200
JOHNSON CITY, TN 37604
Washington County (423) 794-1300
AMBER C PLOUCHA NP-C
Nurse Practitioner
301 MED TECH PKWY, SUITE 240
JOHNSON CITY, TN 37604
Washington County (423) 794-5520
ERIN MCPHERSON
Registered Nurse (Lactation Consultant)
301 MED TECH PKWY, SUITE 160
JOHNSON CITY, TN 37604
Washington County (423) 794-5560

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 Bryan Prudhomme's NPI number?

The NPI number for Bryan Prudhomme is 1528270816. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Where is Bryan Prudhomme located?

Bryan Prudhomme practices at 301 Med Tech Pkwy Ste. 180, Johnson City, TN 37604. The listed phone number is (423) 794-5540.

What is Bryan Prudhomme's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Bryan Prudhomme enrolled in Medicare?

Yes. Bryan Prudhomme is registered in the Medicare PECOS enrollment system.

What insurance does Bryan Prudhomme accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Bryan Prudhomme 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.

When was this NPI record last updated?

The NPPES record for Bryan Prudhomme was last updated on February 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.