NPIMap

Individual provider Active NPI

Charles Famoyin, M.D.

  • Hematology & Oncology Physician
  • Johnson City, TN
National Provider Identifier
1003807355
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
41664 Issued in TN
Practice address
302 Wesley St Ste 3
Johnson City, TN 37601-1741
Phone
(423) 202-3772
Fax
(423) 202-3445
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 41664 TN Primary
Internal Medicine Physician 207R00000X 41664 TN

Addresses

Primary practice location

302 Wesley St Ste 3
Johnson City, TN 37601-1741

Mailing address

302 Wesley St Ste 3
Johnson City, TN 37601-1741
Phone (423) 202-3772

Other identifiers 1

IdentifierTypeStateIssuer
3833830MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070614000122 TN Practitioner - General PracticePractitioner - Hematology/Oncology 9739173980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

138 Industrial Dr
Elizabethton, TN 37643-4644
Phone (423) 542-7007

302 Wesley St
Suite 3
Johnson City, TN 37601-1741
Phone (423) 282-0561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Primary Care CurrentSince Aug 30, 2022 Accepting new patients
Quality of Life Healthcare Inc. Hematology & Oncology CurrentSince Sep 1, 2012 Accepting new patients
East Tennessee Hematology/Oncology Assoc P.C. Past Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine Past Accepting new patients
Trinity Cancer Care, P.C. Past Accepting new patients

Locations

138 Industrial Dr
Elizabethton, TN 37643
Phone (423) 542-7007

302 Wesley St
Ste 3
Johnson City, TN 37601
Phone (423) 202-3772

Interoperability endpoints

  • Direct secure messaging: cfamoyin@qualitylifehc.qrsdm.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1003807355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 WESLEY ST STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011741",
            "telephone_number": "423-202-3772",
            "fax_number": "423-202-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WESLEY ST STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011741",
            "telephone_number": "423-202-3772",
            "fax_number": "423-202-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMOYIN",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "41664",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "41664",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3833830",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.