NPIMap

Organization Active NPI

Pac of Tennessee PC

  • Internal Medicine Physician
  • Bristol, TN
National Provider Identifier
1043856677
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PAC OF TENNESSEE PC
Practice address
1958 West State Street
Suite 2
Bristol, TN 37620-2257
Phone
(423) 573-1502
Fax
(423) 217-0604
NPI assigned
Nov 19, 2019
Last updated
Jun 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Donald Quinn, MDNPI 1447219688
Title
Owner
Phone
(423) 573-1502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1958 West State Street
Suite 2
Bristol, TN 37620-2257

Mailing address

618 Broad St
Bristol, TN 37620-2234
Phone (423) 573-1502

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL GEHRIMED Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200123001090 TN Part B Supplier - Clinic/Group Practice 7517392400 Receives reassigned benefits from 2 practitioners
Practice locations: Bristol, TN

National Provider Directory

National Provider Directory

Locations

1958 W State St
Ste 2
Bristol, TN 37620
Phone (423) 573-1502

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1043856677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 BROAD ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376202234",
            "telephone_number": "423-573-1502",
            "fax_number": "423-217-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 WEST STATE STREET",
            "address_2": "SUITE 2",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376202257",
            "telephone_number": "423-573-1502",
            "fax_number": "423-217-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAC OF TENNESSEE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-573-1502",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GEHRIMED",
            "affiliation": "N",
            "endpointDescription": "Medical Records",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1958 West State Street",
            "address_2": "Suite 2",
            "city": "Bristol",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376202257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.