Individual provider Active NPI

Jeffrey S. Levine, M.D.

  • Gastroenterology Physician
  • Bristol, TN
National Provider Identifier
1245225333
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD031443 Issued in TN
Practice address
235 Medical Park Blvd
Bristol, TN 37620-7455
Phone
(423) 246-6777
Fax
(423) 246-7766
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD031443 TN 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 9

IdentifierTypeStateIssuer
64062763MedicaidKY
100027166OtherTNPHP TENNCARE
3700035MedicaidTN
005824958MedicaidVA
3121717OtherTNBCBS OF TN
396702OtherVAANTHEM
TN0114OtherTNUNITED HEALTHCARE RIVER V
1803462000MedicaidWV
5160031OtherTNAETNA

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
I20110103000195 TN Practitioner - Gastroenterology 0547354441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of Ny Upstate Medical University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-5560

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy12
Upper gastrointestinal (GI) endoscopy for acid reflux76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD031443TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Feb 1, 2025 Accepting new patients

Locations

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

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

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

Organizations & group practices 3

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 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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1245225333",
    "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": {
        "last_name": "LEVINE",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD031443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64062763",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100027166",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700035",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005824958",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "3121717",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "396702",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RIVER V",
            "identifier": "TN0114",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1803462000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5160031",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.