Travis Patton
Individual provider Active NPI Surgical Physician Assistant · Kingsport, TN
NPI 1174924922 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1174924922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 0110004732 (VA)
- Practice address
- 444 Clinchfield St Ste 103
Kingsport, TN 37660-3859 - Phone
- (423) 578-1518
- Fax
- (423) 230-6349
- NPI assigned
- Sep 11, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Lincoln Memorial University Medical Department, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellmont Medical Associates Inc
Blue Ridge Medical Management Corporation
Practice addresses (Care Compare)
111 W Stone Dr
Kingsport, TN 37660-6027
1497 W Elk Ave
Elizabethton, TN 37643-2896
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
408 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4946
444 Clinchfield St
Suite 103
Kingsport, TN 37660-3859
Phone (423) 578-1518
701 Med Tech Pkwy
Suite 300
Johnson City, TN 37604-2365
Phone (423) 232-8301
Hospital & facility affiliations
- Johnson City Medical Center
- Wellmont Holston Valley Medical Center
- Indian Path Community Hospital
- Greeneville Community Hospital
- Sycamore Shoals Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210520001815 | TN | Practitioner - Physician Assistant | 5890017602 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4597 | TN | MD | Occupational Therapist |
| 0110004732 | VA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates, Inc. | Current |
Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current |
Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current |
Accepting new patients | |
| Blue Ridge Medical Management Corporation | Physician Assistant | Past | Accepting new patients |
Locations
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
444 Clinchfield St
Ste 103
Kingsport, TN 37660
Phone (423) 548-1518
16000 Johnston Memorial Dr
Ste 100
Abingdon, VA 24211
Phone (276) 258-1760
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110004732 | VA | |
| Surgical Physician Assistant | 363AS0400X | 0110004732 | VA | Yes |
| Surgical Physician Assistant | 363AS0400X | 4597 | TN | |
| Physician Assistant | 363A00000X | 4597 | TN |
Addresses
Primary practice location
444 Clinchfield St Ste 103
Kingsport, TN 37660-3859
Mailing address
509 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2579
Phone (423) 302-6565
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174924922 | Medicaid | VA | |
| Q031354 | Medicaid | TN | |
| P01552889 | Other | VA | RAILROAD MEDICARE |
Other providers in Kingsport, TN
- Deanna L Patterson
- Ashley Patton
- C Mack Patton
- Robert C Patton
- Suzanne E Patton
- Yonette Paul-Ennis
- Charles E Payne
- Ethan Pearcy
- Caleb Pearson
- Pedirite Medical TN PLLC
All providers in Kingsport, TN · Surgical Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.