| Renuven Aco PLLC | |
|
3209 Bristol Hwy Johnson City TN 37601-1515 | |
| (423) 926-2358 | |
| Not Available |
| Full Name | Renuven Aco PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3209 Bristol Hwy, Johnson City, Tennessee |
| Authorized Official Name and Position | Bert J Smith (CEO) |
| Authorized Official Contact | 4235575706 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renuven Aco PLLC 2717 E Oakland Ave Johnson City TN 37601-1843 Ph: (423) 926-2358 | Renuven Aco PLLC 3209 Bristol Hwy Johnson City TN 37601-1515 Ph: (423) 926-2358 |
| NPI Number | 1568209872 |
|---|---|
| Provider Enumeration Date | 07/12/2024 |
| Last Update Date | 07/17/2026 |
| Certification Date | 07/17/2026 |
| Medicare PECOS PAC ID | 1850820374 |
|---|---|
| Medicare Enrollment ID | O20250129001866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568209872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Nicholas J Dieringer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124003561 PECOS PAC ID: 1850375981 Enrollment ID: I20040616000754 |
| Provider Name | Don E Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245215847 PECOS PAC ID: 6709866817 Enrollment ID: I20040721000138 |
| Provider Name | James a Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184602898 PECOS PAC ID: 0547230096 Enrollment ID: I20040914000203 |
| Provider Name | Carla L Gillespie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295762276 PECOS PAC ID: 0547232878 Enrollment ID: I20050930000636 |
| Provider Name | Charles a Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154344836 PECOS PAC ID: 9537137401 Enrollment ID: I20060209000275 |
| Provider Name | Joseph Radawi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285686451 PECOS PAC ID: 2365481892 Enrollment ID: I20070319000400 |
| Provider Name | Faiza Rehman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407890593 PECOS PAC ID: 0749385979 Enrollment ID: I20070417000680 |
| Provider Name | Kelley V Jefferson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154398105 PECOS PAC ID: 9335210616 Enrollment ID: I20080613000067 |
| Provider Name | Bert Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497839070 PECOS PAC ID: 4587738877 Enrollment ID: I20080805000250 |
| Provider Name | Alicia D Flanary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912187527 PECOS PAC ID: 8527139518 Enrollment ID: I20090311000271 |
| Provider Name | Sabrina D Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477881100 PECOS PAC ID: 7012186562 Enrollment ID: I20110817000925 |
| Provider Name | Brandon Lee Maroney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366726812 PECOS PAC ID: 8123291820 Enrollment ID: I20111025000282 |
| Provider Name | Kathleen J Locker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578698270 PECOS PAC ID: 4082696968 Enrollment ID: I20120123000063 |
| Provider Name | Debra a Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760629547 PECOS PAC ID: 8426203944 Enrollment ID: I20130306000219 |
| Provider Name | Gabriela P Orozco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891968061 PECOS PAC ID: 0143475491 Enrollment ID: I20130313000044 |
| Provider Name | Laura G Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629400064 PECOS PAC ID: 8921242025 Enrollment ID: I20130911000286 |
| Provider Name | Robert Eric Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144305152 PECOS PAC ID: 9133101744 Enrollment ID: I20130920000128 |
| Provider Name | Lauren L Mccroskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861816704 PECOS PAC ID: 4789807256 Enrollment ID: I20140602001704 |
| Provider Name | Diane Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326284217 PECOS PAC ID: 5799904348 Enrollment ID: I20140915001279 |
| Provider Name | Alesha Mcconnell-carmony |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740622281 PECOS PAC ID: 1658504550 Enrollment ID: I20140916001798 |
| Provider Name | Celeste Harnden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316235997 PECOS PAC ID: 5092957712 Enrollment ID: I20140919001898 |
| Provider Name | Katherine J Hodge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548576549 PECOS PAC ID: 3274776067 Enrollment ID: I20141015001954 |
| Provider Name | Kristina M Crocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669889671 PECOS PAC ID: 5294957072 Enrollment ID: I20141111001113 |
| Provider Name | Whitney M Matchette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831504323 PECOS PAC ID: 0446576151 Enrollment ID: I20150223001666 |
| Provider Name | Jennifer a Lay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508254350 PECOS PAC ID: 4789901646 Enrollment ID: I20150402001864 |
| Provider Name | Hollie J Coates-hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689050593 PECOS PAC ID: 8527182161 Enrollment ID: I20160114000987 |
| Provider Name | Mary R Mcnees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043768435 PECOS PAC ID: 7719267426 Enrollment ID: I20170103001511 |
| Provider Name | Kelly Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235675943 PECOS PAC ID: 3779867262 Enrollment ID: I20170301000378 |
| Provider Name | Tiffany Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831648385 PECOS PAC ID: 9931477742 Enrollment ID: I20170620002945 |
| Provider Name | Andrea Baxley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568962413 PECOS PAC ID: 5698039188 Enrollment ID: I20180509002069 |
| Provider Name | Joellen B Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447742259 PECOS PAC ID: 7911257761 Enrollment ID: I20180829001632 |
| Provider Name | Alexandra M Bowling |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073996948 PECOS PAC ID: 5597063495 Enrollment ID: I20180905002536 |
| Provider Name | Alexandria Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346726775 PECOS PAC ID: 1850641036 Enrollment ID: I20180910001185 |
| Provider Name | Megan J Bode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194216184 PECOS PAC ID: 7719230838 Enrollment ID: I20181018002946 |
| Provider Name | Jenna Brooke Cate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013495951 PECOS PAC ID: 1658617980 Enrollment ID: I20190108001816 |
| Provider Name | Krista Nicole Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477028256 PECOS PAC ID: 4385981018 Enrollment ID: I20190202000217 |
| Provider Name | Benjamin Whitfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114468444 PECOS PAC ID: 9739451410 Enrollment ID: I20190304002460 |
| Provider Name | Kayla Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306329818 PECOS PAC ID: 3173862380 Enrollment ID: I20190306001845 |
| Provider Name | Christie L Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194293894 PECOS PAC ID: 3779821806 Enrollment ID: I20190717003683 |
| Provider Name | Hannah Kai Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114561693 PECOS PAC ID: 3173953510 Enrollment ID: I20200424002913 |
| Provider Name | Christy Bantong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598295826 PECOS PAC ID: 5799057188 Enrollment ID: I20200604003242 |
| Provider Name | Brittany Baldwin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043740558 PECOS PAC ID: 6103198437 Enrollment ID: I20200716003137 |
| Provider Name | Jennifer Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649801994 PECOS PAC ID: 5496179145 Enrollment ID: I20200728001308 |
| Provider Name | Hannah Gump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144823121 PECOS PAC ID: 6507272770 Enrollment ID: I20210312001654 |
| Provider Name | Jean Bea Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559745 PECOS PAC ID: 8921314162 Enrollment ID: I20210408000900 |
| Provider Name | Julie Markus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477127280 PECOS PAC ID: 5698178937 Enrollment ID: I20210726000393 |
| Provider Name | Kelly Hinkle Pugh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447839105 PECOS PAC ID: 7113322348 Enrollment ID: I20210825003047 |
| Provider Name | Kimberly a Crain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871255174 PECOS PAC ID: 1557737558 Enrollment ID: I20221017000942 |
| Provider Name | Ina Vate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467963942 PECOS PAC ID: 0547515454 Enrollment ID: I20230127001562 |
| Provider Name | Amanda W Works |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215641915 PECOS PAC ID: 1658745856 Enrollment ID: I20230329001008 |
| Provider Name | Kara Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295141471 PECOS PAC ID: 1951521913 Enrollment ID: I20230726003544 |
| Provider Name | Ashley L Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184306847 PECOS PAC ID: 2961866397 Enrollment ID: I20230918003036 |
| Provider Name | Amber Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215466735 PECOS PAC ID: 1759737042 Enrollment ID: I20231023002203 |
| Provider Name | Hailey B Buehrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003689670 PECOS PAC ID: 2961859897 Enrollment ID: I20231114001524 |
| Provider Name | Leslie Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538667498 PECOS PAC ID: 9638433147 Enrollment ID: I20240415000594 |
| Provider Name | Dana Dianne Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255190013 PECOS PAC ID: 7911447750 Enrollment ID: I20240909000746 |
| Provider Name | Camille Lee Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639825300 PECOS PAC ID: 6709252893 Enrollment ID: I20250109000297 |
| Provider Name | Mandy Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497579916 PECOS PAC ID: 3779011143 Enrollment ID: I20250113002653 |
| Provider Name | Jordan Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609601053 PECOS PAC ID: 6103355714 Enrollment ID: I20250130003924 |
| Provider Name | Erin Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952019697 PECOS PAC ID: 4587192745 Enrollment ID: I20250207001946 |
| Provider Name | Cheryl Ann Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275396301 PECOS PAC ID: 5597295204 Enrollment ID: I20250211001834 |
| Provider Name | Patricia Mcdougall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326252685 PECOS PAC ID: 8426139155 Enrollment ID: I20250305003982 |
| Provider Name | Joselyn Ghulam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992137277 PECOS PAC ID: 5799005351 Enrollment ID: I20250321000497 |
| Provider Name | Galina Rader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932138658 PECOS PAC ID: 1658314315 Enrollment ID: I20250321003077 |
| Provider Name | Cristy Rickita Mccrobey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003616459 PECOS PAC ID: 2365961133 Enrollment ID: I20250523002297 |
| Provider Name | Mckayla Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073403127 PECOS PAC ID: 9133628878 Enrollment ID: I20250819002299 |
| Provider Name | Erin Patricia Ann Baliad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225315310 PECOS PAC ID: 7113189838 Enrollment ID: I20250904000347 |
| Provider Name | Shiva Mohan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821619792 PECOS PAC ID: 5193141794 Enrollment ID: I20251024000839 |
| Provider Name | Helen Kim Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457095150 PECOS PAC ID: 2466940945 Enrollment ID: I20251024004050 |
| Provider Name | Katherine Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669117610 PECOS PAC ID: 0648658617 Enrollment ID: I20260513003127 |
University Physicians Practice Group-etsu Family Medicine Johnson City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 W Walnut St, Johnson City, TN 37604 Phone: 423-439-6464 Fax: 423-439-7118 |
Wyche & Wyche, M.D., P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2406 Susannah St, Johnson City, TN 37601 Phone: 423-282-2542 Fax: 423-282-5447 |
Twisted Roots Medical Mission Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Northpark Dr Ste 2c, Johnson City, TN 37604 Phone: 423-276-1298 Fax: 877-682-3707 |
Imperial Healthcare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1604 Lamons Ln Ste 230, Johnson City, TN 37604 Phone: 423-930-5168 Fax: 423-328-0193 |
Ballad Health Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 N State Of Franklin Rd, Suite 135b, Johnson City, TN 37604 Phone: 423-431-4866 Fax: 423-431-2372 |
New Life Chiropractic and Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 514 E Watauga Ave, Johnson City, TN 37601 Phone: 423-928-4101 |