Individual provider Active NPI

Brian Keith Dockery, M.D.

  • Interventional Cardiology Physician
  • Cookeville, TN
National Provider Identifier
1083743413
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
31307 Issued in TN
Practice address
228 W 4TH St
Suite 200
Cookeville, TN 38501-2488
Phone
(931) 372-0405
Fax
(931) 372-0463
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 31307 TN
Interventional Cardiology Physician 207RI0011X 31307 TN Primary

Addresses

Primary practice location

228 W 4TH St
Suite 200
Cookeville, TN 38501-2488

Mailing address

228 W 4TH St
Suite 200
Cookeville, TN 38501-2488
Phone (931) 372-0405

Other identifiers 2

IdentifierTypeStateIssuer
4288696OtherTNBCBS
1506018MedicaidTN

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
I20040331001047 TN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1355333204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Tennessee, HSC, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRMC Mso Sub 1 IncorporatedGroup PAC ID 1052332830, 21 clinicians
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians

Practice addresses (Care Compare)

228 W 4TH St
Suite 200
Cookeville, TN 38501-2489
Phone (931) 372-0405

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.5 of 100Reported as individual
Quality
71.29
Promoting interoperability
0
Improvement activities
40
Cost
74.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31307TNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CRMC Mso Sub 1, Incorporated CurrentSince Jan 1, 2011 Accepting new patients
Hma Fentress County General Hospital LLC Past Accepting new patients
Hma Fentress County General Hospital Cardiovascular Disease Past Accepting new patients
Cookeville Regional Medical Center Cardiovascular Disease Past Accepting new patients

Locations

228 W 4th St
Ste 200
Cookeville, TN 38501
Phone (931) 372-0405

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

106 Henry St
Crossville, TN 38555
Phone (931) 783-4770

310 Oak St
Livingston, TN 38570
Phone (931) 403-0559

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 3

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1083743413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST",
            "address_2": "SUITE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012488",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKERY",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "31307",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "31307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4288696",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506018",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.