Jeffrey S Weatherall, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

34933 Issued in TN

Practice address

135 W Ravine
Ste 5B
Kingsport, TN 37660-3847

Phone

(423) 224-3460

Fax

(423) 224-3465

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Anesthesiology

Education

Knoxville Medical College, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffrey.weatherall.1@3374.direct.athenahealth.com

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.

• Paragon Anesthesia PC

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1538174974
  Medicare reassignment Care Compare group NPD
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• East Tennessee Ambulatory Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Johnson City, TN
  • NPI 1659360071
  NPD
• American Anesthesiology Group of Tennessee, P. C.

  • Anesthesiology Physician
  • Kingsport, TN
  • NPI 1114927738
  NPD (past)
• East Tennessee Medical Group, PC

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1942238902
  NPD (past)
• Singing River Health System

  dba Inpatient Physician Services

  • Internal Medicine Physician
  • Pascagoula, MS
  • NPI 1134283419
  NPD (past)

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

• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1093752081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303535510",
            "telephone_number": "844-294-5114",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RAVINE",
            "address_2": "STE 5B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERALL",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "34933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00303258",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010258693",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3868408",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4119268",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64032592",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Alexis Watson, FNP
• Sean Joseph Watson, M.D.
• Myra Watts, FNP
• Alia Way, PA-C
• Marta Jean Wayt, DO
• Susie Weatherall, OTR/L
• Philip Aaron Weatherford, PA-C
• Robert Keltner Weatherly III, BSW
• Rebekah C Weaver, NP
• Harold J Webb, MD

• Anesthesiology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.

Verify at the official NPI Registry.