Individual provider Active NPI

Sukhvir Singh, DO

  • Pediatrics Physician
  • Elizabethton, TN
National Provider Identifier
1013406479
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4472 Issued in TN
Practice address
1505 W Elk Ave Ste 1
Elizabethton, TN 37643-2848
Phone
(423) 543-7919
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4472 TN Primary

Addresses

Primary practice location

1505 W Elk Ave Ste 1
Elizabethton, TN 37643-2848

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

325 N State Of Franklin Rd
Ground Floor
Johnson City, TN 37604-6056
Phone (423) 439-7320

Other practice location 2

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other identifiers 1

IdentifierTypeStateIssuer
Q041993MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823001141 TN Practitioner - Pediatric Medicine 7416352950 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4472TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Pediatrics CurrentSince Aug 15, 2021 Accepting new patients

Locations

1505 W Elk Ave
Ste 1
Elizabethton, TN 37643
Phone (423) 543-7919

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1013406479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W ELK AVE STE 1",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432848",
            "telephone_number": "423-543-7919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N State Of Franklin Rd",
            "address_2": "Ground Floor",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046056",
            "country_code": "US",
            "telephone_number": "423-439-7320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINGH",
        "first_name": "SUKHVIR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "4472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q041993",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.