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NPI Code Detail

MEDICARE: JOHN N. GERNERT

MEDICARE: JOHN N. GERNERT
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
1213ES0103XFoot & Ankle Surgery PodiatristDPM0000000198TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
24354855OTHERMEDICARE
3103G703357OTHERMEDICARE GROUP #/PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11629408703OTHERTNNPI
41194867580OTHERTNNPI
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629408703
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN N. GERNERT
Provider Business Mailing 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
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 : OFFICE MANAGER/AM
Name : MS. TANNA GREEN
Credential :
Telephone Number : 423-476-3773
Provider Enumeration Date : 11/26/2013
Last Update Date : 12/30/2025

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