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

Holly Renee Nummerdor, DO

Individual provider Family Medicine Physician · NPI 1114504545

Holly Renee Nummerdor, DO is a Family Practice in Johnson City, Tennessee. Qualified in 2021, 5 years ago. Practices with State of Franklin Healthcare Associates, PLLC, a 265-clinician group, works from 4 locations, accepts Medicare assignment and offers telehealth. Licensed in Tennessee.

Years since qualifying
5
Licensed in
TN
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

701 Med Tech Pkwy Ste 401
Johnson City, TN 37604-2372
Phone: (423) 631-0646
Fax: (423) 631-0647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1497 W Elk Ave Ste 21, Elizabethton, TN 37643-2896 — (423) 542-7420
  • 102 E Ravine Rd, Kingsport, TN 37660-3814 — (920) 210-5194
  • 1242 W Shipley Ferry Rd, Kingsport, TN 37663-3323 — (423) 239-7300

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5826 (TN)

Record details

NPI number1114504545
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 24, 2021
Last updated in NPPESJuly 28, 2026
Certification dateJuly 28, 2026
Mailing address1021 W Oakland Ave Ste 310, Johnson City, TN 37604-2192

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice State Of Franklin Healthcare Associates, Pllc — 265 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Johnson City