Individual provider Active NPI

Jim R Littlejohn, MD

  • Urology Physician
  • Kingsport, TN
National Provider Identifier
1225036841
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
29347 Issued in TN
Practice address
822 Broad St
Kingsport, TN 37660-3718
Phone
(423) 246-6251
Fax
(423) 246-7230
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 29347 TN Primary

Addresses

Primary practice location

822 Broad St
Kingsport, TN 37660-3718

Mailing address

822 Broad St
Kingsport, TN 37660-3718
Phone (423) 246-6251

Other identifiers 1

IdentifierTypeStateIssuer
3371556MedicaidTN

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
I20101026000030 TN Practitioner - Urology 8921110065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Associates of Kingsport, P. C.Group PAC ID 7113949801, 2 clinicians

Practice addresses (Care Compare)

822 Broad St
Kingsport, TN 37660-3718

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.33 of 100Reported as individual
Quality
86.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of Kingsport, P. C. Urology CurrentSince Jul 15, 1997 Accepting new patients
Wellmont Medical Associates, Inc. Past Accepting new patients

Locations

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

822 Broad St
Kingsport, TN 37660
Phone (423) 246-6251

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 5

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1225036841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "JIM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "29347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3371556",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.