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

Jake Sides

Individual provider Surgery Physician · NPI 1003279662

Jake Sides is a General Surgery in Bristol, Tennessee. Qualified in 2016, 10 years ago. Practices with Wps Providers Inc, a 83-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
10
Licensed in
TN, VA
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

1 Medical Park Blvd Ste 250W
Bristol, TN 37620-7431
Phone: (423) 844-6620
Fax: (423) 844-6626
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 594 Radio Hill Rd, Marion, VA 24354-4224 — (423) 844-6620

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 63286 (TN)
Surgery Physician Taxonomy 208600000X · Licence 0101275797 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1003279662
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 31, 2016
Last updated in NPPESJuly 3, 2024
Certification dateJuly 3, 2024
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 specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Wps Providers Inc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Bristol