Jerry K Gouge, PA-C is a medicare enrolled "Physician Assistant" physician in Knoxville, Tennessee. His current practice location is
2018 Western Ave, Knoxville, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(865) 544-0406.
Jerry K Gouge is licensed to practice in Tennessee (license number 1728) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720218050.
Physician's Profile
| Full Name | Jerry K Gouge |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 2018 Western Ave, Knoxville, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720218050
- Provider Enumeration Date: 07/21/2009
- Last Update Date: 12/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 6709923725
- Enrollment ID: I20091023000627
Medical Identifiers
Medical identifiers for Jerry K Gouge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720218050 | NPI | - | NPPES |
| 1515542 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 1728 (Tennessee) | Secondary |
| 363A00000X | Physician Assistant | 1728 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jerry K Gouge is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jerry K Gouge, PA-C
30 Burton Hills Blvd, Ste 175,
Nashville, TN 37215-6403
Ph: (615) 988-2014 | Jerry K Gouge, PA-C
2018 Western Ave,
Knoxville, TN 37921-5718
Ph: (865) 544-0406 |
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