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MR. JEDEDIAH A GILLIAM FNP-BC
NPI 1841873718
Nurse Practitioner - Family in Johnson City, TN

Active since April 29, 2021PECOS Enrolled
809 LAMONT ST, JOHNSON CITY, TN 37604(423) 926-1171(423) 979-3685 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 8, 2022, Apr 29, 2021 (2 updates tracked since 2021).

About Mr. Jedediah A Gilliam Fnp-bc NPPES

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

MR. JEDEDIAH A GILLIAM FNP-BC (NPI 1841873718) is an individual family provider in Johnson City, Tennessee, licensed in Tennessee (29204) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841873718
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. JEDEDIAH A GILLIAMCredential: FNP-BC
Location Address809 LAMONT STJohnson City, TN 37604-5453
Mailing Address809 Lamont StJohnson City, TN 37604-5453 · (423) 926-1171
Phone(423) 926-1171
Fax(423) 979-3685
Sole ProprietorNo
Enumeration DateApril 29, 2021
Last NPPES UpdateJune 10, 20262 updates tracked since enumeration
NPPES CertifiedJune 10, 2026
✔ NPI 1841873718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 29204
809 LAMONT ST, Johnson City, TN 37604
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jedediah A Gilliam Fnp-bc 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.

Medicare Billing Reassignment

Medicare enrollment records show Jedediah Gilliam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Urgent Care Of Erwin, LLC
11 mi
Urgent Care
800 S MOHAWK DR, SUITE E
Erwin, TN 37650
  • Reassigned Medicare billing, Tennessee enrollment
  • 4 clinicians in this Medicare group
NPI 1609158120 (423) 735-0500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. GRANT MICHAEL FEATHERS PHARMD
Pharmacist
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
HUNTER KELSEY CLARK
Registered Nurse
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 306-1716
DR. TAKEEM YOUNG
Physical Medicine & Rehabilitation
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
CAMERON H ATKISON OTR
Occupational Therapist
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
MARY HELEN FUQUA CTRS
Recreation Therapist
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
KENDRA LYNN RICE PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
MARCHETA RAQUEL EJIWUMI LMSW
Social Worker
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171
JACQUELINE NICOLE MCCARTT LCSW
Social Worker (Clinical)
809 LAMONT ST
JOHNSON CITY, TN 37604
Washington County (423) 926-1171

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 Jedediah Gilliam's NPI number?

The NPI number for Jedediah Gilliam is 1841873718. It was assigned to this individual provider in the NPPES registry on April 29, 2021.

Where is Jedediah Gilliam located?

Jedediah Gilliam practices at 809 Lamont St, Johnson City, TN 37604. The listed phone number is (423) 926-1171.

What is Jedediah Gilliam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jedediah Gilliam enrolled in Medicare?

Yes. Jedediah Gilliam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jedediah Gilliam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jedediah Gilliam reassigns Medicare benefits to Urgent Care Of Erwin, LLC (Erwin, TN). 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 Jedediah Gilliam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jedediah Gilliam accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Jedediah Gilliam 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 Jedediah Gilliam was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.