Individual provider Active NPI

William Scott Dodd, M.D.

  • Pediatrics Physician
  • Johnson City, TN
National Provider Identifier
1134415698
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
53344 Issued in TN
Practice address
325 N State of Franklin Rd
Ground Floor
Johnson City, TN 37604
Phone
(423) 439-7320
Fax
(423) 439-7343
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 53344 TN Primary
Internal Medicine Physician 207R00000X 53344 TN

Addresses

Primary practice location

325 N State of Franklin Rd
Ground Floor
Johnson City, TN 37604

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

325 N State Of Franklin Rd Fl 2
Johnson City, TN 37604-6092
Phone (423) 439-7280

Other identifiers 3

IdentifierTypeStateIssuer
1134415698MedicaidVA
1134415698MedicaidNC
Q015492MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150713002512 NC Practitioner - Internal Medicine 1355654880
I20151116001439 TN Practitioner - Pediatric MedicinePractitioner - Internal Medicine 1355654880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

325 N State of Franklin Rd
FL 2
Johnson City, TN 37604-6092
Phone (423) 439-7280

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53344TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Sep 1, 2015 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 1, 2015 Accepting new patients
Medical Education Assistance Corporation Internal Medicine CurrentSince Jun 19, 2017 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

325 N State of Franklin Rd
Fl 2
Johnson City, TN 37604
Phone (423) 439-7280

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1134415698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "address_2": "GROUND FLOOR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N State Of Franklin Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046092",
            "country_code": "US",
            "telephone_number": "423-439-7280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DODD",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "53344",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "53344",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134415698",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134415698",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015492",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.