NPIMap

Organization Active NPI

Gastroenterology Associates

  • Specialist
  • Bristol, TN
National Provider Identifier
1235330994
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GASTROENTEROLOGY ASSOCIATES
Practice address
235 Medical Park Blvd
Bristol, TN 37620-7455
Phone
(423) 246-6777
Fax
(423) 246-7766
NPI assigned
May 30, 2007
Last updated
May 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Authorized official

Name
Mr. Mark Bartley, CPA
Title
Chief Administrative Officer
Phone
(423) 246-6777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

235 Medical Park Blvd
Bristol, TN 37620-7455

Mailing address

135 W Ravine Rd
Suite 3a
Kingsport, TN 37660-3847
Phone (423) 246-6777

Other identifiers 1

IdentifierTypeStateIssuer
3700035MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070924000124 TN Part B Supplier - Clinic/Group Practice 4789781048 Receives reassigned benefits from 48 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bristol, TN; Kingsport, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0975038Gastroenterology Associates235 Medical Park Blvd, Bristol, TN 37620Certificate of waiverJun 25, 2028

National Provider Directory

National Provider Directory

Locations

135 W Ravine Rd
Kingsport, TN 37660
Phone (423) 246-9752

135 W Ravine Rd
Ste 3-A
Kingsport, TN 37660
Phone (423) 246-6777

616 Campus Dr
Abingdon, VA 24210
Phone (276) 525-4487

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1235330994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "SUITE 3A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-246-6777",
            "fax_number": "423-246-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207455",
            "telephone_number": "423-246-6777",
            "fax_number": "423-246-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "BARTLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "423-246-6777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700035",
            "state": "TN"
        }
    ],
    "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 May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.