Active NPI
Michael R Fleenor, M.D.
- Orthopaedic Surgery Physician
- Bristol, TN
National Provider Identifier
1215964911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 18558
- Practice address
- 260 Midway Medical Park
Ste 100
Bristol, TN 37620-1721 - Phone
- (423) 968-4446
- Fax
- (423) 968-4802
- NPI assigned
- Jun 27, 2006
- Last updated
- Mar 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 18558 | TN | Primary |
Addresses
Primary practice location
260 Midway Medical Park
Ste 100
Bristol, TN 37620-1721
Mailing address
260 Midway Medical Park
Ste 100
Bristol, TN 37620-1721
Phone (423) 968-4446
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3048090 | Medicaid | TN | |
| 006404774 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18558 | TN | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1215964911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 MIDWAY MEDICAL PARK",
"address_2": "STE 100",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376201721",
"telephone_number": "423-968-4446",
"fax_number": "423-968-4802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 MIDWAY MEDICAL PARK",
"address_2": "STE 100",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376201721",
"telephone_number": "423-968-4446",
"fax_number": "423-968-4802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEENOR",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TN",
"license": "18558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3048090",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006404774",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.