Provider Demographics
NPI:1811971997
Name:KERRIGAN, JAMES RICHARD (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:KERRIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15004
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901
Mailing Address - Country:US
Mailing Address - Phone:865-522-9730
Mailing Address - Fax:865-637-2520
Practice Address - Street 1:2018 CLINCH AVE, SOUTH TOWER
Practice Address - Street 2:2ND FLOOR
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916
Practice Address - Country:US
Practice Address - Phone:865-971-7400
Practice Address - Fax:865-541-8611
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004012402080P0205X
TN00000248352080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1516053Medicaid
VA10196736Medicaid
TN4247746OtherBCBS
NC804923OtherPARTNERS
4401155OtherAETNA
NC890598UMedicaid
NCD7731OtherMEDCOST
SCQ24835Medicaid
NC0598UOtherBCBS
WV3810003260Medicaid
WV3810003260Medicaid
TN1516053Medicaid