MEDICARE: DR. JOHN NORMAN GERNERT D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	DPM000000198	TN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	198	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	103G703357	OTHER	TN	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3350757	OTHER	TN	PTAN
5	T61072	OTHER	TN	UPIN

General Provider Information

NPI Number	:	1194867580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN NORMAN GERNERT D.P.M

Provider Business Mailing Address
First Line	:	105 KEITH ST NW STE 3
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-1704
Country	:	US
Telephone Number	:	423-476-3773
Fax Number	:	423-476-8529

Provider Business Practice Location Address
First Line	:	105 KEITH ST NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-1704
Country	:	US
Telephone Number	:	423-476-3773
Fax Number	:	423-476-8529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	12/30/2025

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