NPIMap

Individual provider Active NPI

Amanda A Dove, MD

  • Family Medicine Physician
  • Rogersville, TN
National Provider Identifier
1093978330
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47342 Issued in TN
Practice address
405 Scenic Dr
Rogersville, TN 37857-2441
Phone
(423) 272-2111
Fax
(423) 272-7667
NPI assigned
Jul 8, 2008
Last updated
Aug 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30920 SC
Family Medicine Physician 207Q00000X 47342 TN Primary

Addresses

Primary practice location

405 Scenic Dr
Rogersville, TN 37857-2441

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110818000171 TN Practitioner - Family Practice 0042489510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

105 W Stone Dr
Kingsport, TN 37660-3256

322 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 217-1360

350 Steeles Rd
Unit 1
Bristol, TN 37620-9532
Phone (423) 844-4925

482 Park Blvd
Suite a
Rogersville, TN 37857-6927
Phone (423) 272-6800

4848 Fort Henry Dr
Kingsport, TN 37663-3347
Phone (423) 239-5141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30920SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates Inc Family Medicine Current Accepting new patients

Locations

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

Interoperability endpoints

  • Direct secure messaging: amandadove@hmgpath.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1093978330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-224-3250",
            "fax_number": "423-224-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SCENIC DR",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572441",
            "telephone_number": "423-272-2111",
            "fax_number": "423-272-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE",
        "first_name": "AMANDA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "30920",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

Verify at the official NPI Registry.