Individual provider Active NPI

Donald Matthew Cobb, D.O.

  • Diagnostic Radiology Physician
  • Abingdon, VA
National Provider Identifier
1205864329
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0102201845 Issued in VA
Practice address
Hospital Drive
Glenrochie Professional BLDG
Abingdon, VA 24210
Phone
(276) 628-9331
NPI assigned
Jun 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0102201845 VA Primary

Addresses

Primary practice location

Hospital Drive
Glenrochie Professional BLDG
Abingdon, VA 24210

Mailing address

262 Overlake Dr
Bristol, VA 24201-1806
Phone (276) 628-9331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031230000765 TN Practitioner - Diagnostic Radiology 0345148102 Reassigns benefits to 1 organization
I20061020000127 VA Practitioner - Diagnostic Radiology 0345148102 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1584TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Radiology, P.C. Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

3053 W State St
Bristol, TN 37620
Phone (423) 301-6567

4289 Bonny Oaks Dr
Ste 106
Chattanooga, TN 37406

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205864329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 OVERLAKE DR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242011806",
            "telephone_number": "276-628-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL DRIVE",
            "address_2": "GLENROCHIE PROFESSIONAL BLDG",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "24210",
            "telephone_number": "276-628-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "DONALD",
        "middle_name": "MATTHEW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0102201845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.