Active NPI
Andy A Roberts, M.D.
- Family Medicine Physician
- Greeneville, TN
National Provider Identifier
1013900943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26381
- Practice address
- 109 E Church St
Greeneville, TN 37745-5603 - Phone
- (423) 638-4131
- Fax
- (423) 638-9239
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26381 | TN | Primary |
Addresses
Primary practice location
109 E Church St
Greeneville, TN 37745-5603
Mailing address
PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3005285 | Other | TN | BC BS TN |
| 3089112 | Medicaid | TN | |
| 7 | Other | TN | JOHN DEERE |
| 3005285 | Other | TN | BLUE CARE |
| 00006415 | Other | NHC HEALTH BENEFITS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110210000250 | TN | Practitioner - Family Practice | 5092816439 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Tennessee, HSC, College of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
109 E Church St
Greeneville, TN 37745-5603
Phone (423) 638-4131
Hospital & facility affiliations
- Amedisys Home Health Care
- Greeneville Community Hospital
- Wellmont Holston Valley Medical Center
- Johnson City Medical Center
- Franklin Woods Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26381 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holston Medical Group PC | Family Medicine | Current | Accepting new patients |
Locations
350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925
109 E Church St
Greeneville, TN 37745
Phone (423) 638-4131
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.
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Morristown, TN
- NPI 1639127319
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1114033628
Hospital
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1013900943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376620009",
"telephone_number": "423-857-2066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 E CHURCH ST",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377455603",
"telephone_number": "423-638-4131",
"fax_number": "423-638-9239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ANDY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "26381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS TN",
"identifier": "3005285",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3089112",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "7",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE",
"identifier": "3005285",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHC HEALTH BENEFITS",
"identifier": "00006415",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.