James W Shine, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD28372 Issued in TN

Practice address

1901 S Shady St
Mountain City, TN 37683-2021

Phone

(423) 727-1103

Fax

(423) 727-1140

NPI assigned

Apr 22, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  NPD
• Blue Ridge Medical Management Corporation

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1164794525
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• LP Mountain City LLC

  • Nursing Facility/Intermediate Care Facility
  • Mountain City, TN
  • NPI 1235320524
  NPD (past)

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1194781724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1103",
            "fax_number": "423-727-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1103",
            "fax_number": "423-727-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD28372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3803906",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009917",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0167",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194781724",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4062642",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Rhymer
• Jordan Robertson, PHARMD
• Bethany Monique Rock, FNP
• Rural Health Services Consortium of Upper East Tennessee Inc
• SHC Medical Partners of Tennessee, LLC
• Susanne Mayer Shine, MD
• Adam F Silberman, M.D.
• Kayla Dawn Simpson, RN
• Sisters Caring Hearts Family Medicine Inc
• Tracy M Slemp, FNP

• Family Medicine Physician in Mountain City, TN
• Providers in Mountain City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.