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

Jerome Patrick Tina

Individual provider Medical Physician Assistant · NPI 1467187229

Jerome Patrick Tina is a Physician Assistant in Jonesborough, Tennessee. Qualified in 2022, 4 years ago. Practices with Blue Ridge Medical Management Corporation, a 286-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
4
Licensed in
TN, VA
In the registry since
2022
Specialties on file
4

Practice location Address checks out

155 Jim Ford Rd
Jonesborough, TN 37659-3129
Phone: (516) 967-0805
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 800 S Mohawk Dr Ste C, Erwin, TN 37650-2124 — (423) 735-4750

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5240 (TN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 0110010539 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 5240 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 0110010539 (VA)

Record details

NPI number1467187229
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 17, 2022
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026
Mailing address155 Jim Ford Rd, Jonesborough, TN 37659-3129

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Blue Ridge Medical Management Corporation — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Jonesborough