Individual provider Active NPI

Scott E Maynard, MD

  • Anesthesiology Physician
  • Kingsport, TN
National Provider Identifier
1235160888
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
40808 Issued in TN
Practice address
135 W Ravine Rd
Suite 5-B
Kingsport, TN 37660-3847
Phone
(423) 224-3460
Fax
(423) 224-3465
NPI assigned
Jul 5, 2006
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 16269 ND
Anesthesiology Physician 207L00000X 40808 TN Primary

Addresses

Primary practice location

135 W Ravine Rd
Suite 5-B
Kingsport, TN 37660-3847

Mailing address

PO Box 535744
Atlanta, GA 30353-5510
Phone (844) 294-5114

Other practice location 1

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 857-5000

Other identifiers 4

IdentifierTypeStateIssuer
010343488MedicaidVA
3820575MedicaidTN
4127819OtherBCBST
P00337665OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL, DC, MD, MI5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20061013000308 TN Practitioner - Anesthesiology 9335145374 Reassigns benefits to 1 organization
I20200303002816 AL Practitioner - Anesthesiology 9335145374 Reassigns benefits to 4 organizations
I20230111000214 DC Practitioner - Anesthesiology 9335145374 Reassigns benefits to 3 organizations
I20230821000567 MD Practitioner - Anesthesiology 9335145374 Reassigns benefits to 3 organizations
I20251015003716 MI Practitioner - Anesthesiology 9335145374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
81.01
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16269NDMDAnesthesiology Physician
40808TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physynergy, LLC Anesthesiology CurrentSince Mar 1, 2021 Accepting new patients
Physynergy, LLC Anesthesiology Current Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Anesthesiologists Associated PC CurrentSince Jan 20, 2020 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Dec 1, 2022 Accepting new patients
Northstar Anesthesia of Maryland LLC Anesthesiology CurrentSince Apr 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Dec 1, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. Anesthesiology CurrentSince Aug 1, 2019 Accepting new patients
USA Health Anesthesia Billing Services, LLC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Spectrum Health Primary Care Partners Anesthesiology CurrentSince Sep 1, 2025 Accepting new patients
First Colonies Anesthesia Associates, LLC Anesthesiology CurrentSince Sep 24, 2023 Accepting new patients
Anesthesiologists Associated PC Anesthesiology CurrentSince Jan 20, 2020 Accepting new patients
Anesthesia Company, LLC Anesthesiology CurrentSince Jul 15, 2023 Accepting new patients
Providence Hospital Current Accepting new patients
Providence Hospital Anesthesiology CurrentSince Sep 14, 2020 Accepting new patients
American Anesthesiology Group of Tennessee, P. C. Anesthesiology PastSince Oct 1, 2012 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

3719 Dauphin St
Mobile, AL 36608
Phone (251) 342-3000

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

5 N La Plata Ct
Ste 201
La Plata, MD 20646
Phone (301) 609-4000

70 Sherry Ln
Ste 101
Prnc Frederck, MD 20678
Phone (410) 889-2040

800 Prince Frederick Blvd
Prnc Frederck, MD 20678
Phone (410) 535-2270

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230

8905 Fairview Rd
Silver Spring, MD 20910
Phone (888) 554-0631

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 416-2000

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1235160888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303535510",
            "telephone_number": "844-294-5114",
            "fax_number": "865-691-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "SUITE 5-B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-224-3460",
            "fax_number": "423-224-3465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-857-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "16269",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "40808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010343488",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3820575",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4127819",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00337665",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.