Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jason Glen Funderburk, MD

Individual provider Vascular & Interventional Radiology Physician · NPI 1104883966

Dr. Jason Glen Funderburk, MD is an Interventional Radiology in Knoxville, Tennessee. Graduated from Louisiana State University School of Medicine in New Orleans in 1999, 27 years ago. Practices with Great Falls Clinic LLC, a 72-clinician group and accepts Medicare assignment. Licensed in Florida, Michigan and Tennessee.

Years since qualifying
27
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
FL, MI, TN
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

116 Concord Rd Ste 500
Knoxville, TN 37934-2940
Phone: (865) 777-6880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular & Interventional Radiology Physician (primary) Taxonomy 2085R0204X · Licence 47153 (TN)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence ME 93065 (FL)
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X · Licence 4301102162 (MI)

Record details

NPI number1104883966
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 27, 2006
Last updated in NPPESApril 9, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL RADIOLOGY
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 1999 (27 years in practice)
Group practice Great Falls Clinic Llc — 72 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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