MR. JONATHAN TYLER WHITE (PA) – Physician Assistant, NPI 1154998540
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,118 PHYSICIAN ASSISTANT in TN
Provider Addresses for MR. JONATHAN TYLER WHITE (PA)
5663 Highway 90
Clairfield, TN 377153632
Phone: (423) 784-6135
Type: Location
107 S MAIN ST
JELLICO, TN 377622154
Phone: (423) 784-8492
Fax: (423) 784-8358
Type: Mailing
1770 LAKE CUMBERLAND RD
MOUNT VERNON, KY 404568431
Phone: (606) 256-2195
Type: Mailing
965 S Highway 25 W
Williamsburg, KY 407691608
Phone: (606) 549-2656
Type: Location
550 Sunset Trl
Jellico, TN 377622343
Phone: (423) 784-5771
Type: Location
402 CUMBERLAND AVE
WILLIAMSBURG, KY 407691238
Phone: (606) 549-2656
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210929003751 | I | Physician Assistant | KY | TBD |
| I20230726000961 | I | Physician Assistant | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37715)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | TN | |
| Physician Assistant | TN | |
| R H E U M A T O L O G Y | KY | |
| Physician Assistant | KY | |
| Nurse Practitioner | KY | |
| Physician Assistant | KY | |
| - | TN | |
| Clinical Social Worker | NY | |
| Physician Assistant | TN | |
| Physician Assistant | KY |
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