Individual provider Active NPI

David A Vastine, M.D.

  • Internal Medicine Physician
  • Sevierville, TN
National Provider Identifier
1154429033
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000039679 Issued in TN
Practice address
744 Middle Creek Rd 108
Sevierville, TN 37862-5036
Phone
(865) 446-9500
Fax
(865) 446-9501
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000039679 TN Primary

Addresses

Primary practice location

744 Middle Creek Rd 108
Sevierville, TN 37862-5036

Mailing address

744 Middle Creek Rd 108
Sevierville, TN 37862-5036
Phone (865) 446-9500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Vastine.David@covenanthealth.cernerdirect.com

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
I20050712001045 TN Practitioner - Internal Medicine 0143256057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Knoxville, TN, CCN 447312
  • Leconte Medical Center Hospital, Sevierville, TN, CCN 440081

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000039679TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Nov 1, 2012 Accepting new patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2012 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

744 Middle Creek Rd
Ste 108
Sevierville, TN 37862
Phone (865) 446-9500

Interoperability endpoints

  • Direct secure messaging: vastine.david@covenanthealth.cernerdirect.com

Organizations & group practices 2

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 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1154429033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD 108",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625036",
            "telephone_number": "865-446-9500",
            "fax_number": "865-446-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD 108",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625036",
            "telephone_number": "865-446-9500",
            "fax_number": "865-446-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTINE",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000039679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Vastine.David@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "744 MIDDLE CREEK RD 108",
            "city": "SEVIERVILLE",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378625036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.