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

Q: 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.

Q: What is Jedediah Gilliam's specialty?

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

Q: 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 3 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.

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: October 04, 2026.

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

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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

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Medicare Participation & PECOS CMS

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

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.

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