Active NPI
Jeffrey S. Levine, M.D.
- Gastroenterology Physician
- Bristol, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD031443
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64062763 | Medicaid | KY | |
| 100027166 | Other | TN | PHP TENNCARE |
| 3700035 | Medicaid | TN | |
| 005824958 | Medicaid | VA | |
| 3121717 | Other | TN | BCBS OF TN |
| 396702 | Other | VA | ANTHEM |
| TN0114 | Other | TN | UNITED HEALTHCARE RIVER V |
| 1803462000 | Medicaid | WV | |
| 5160031 | Other | TN | AETNA |
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
Enrollment records 1
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
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-5560
Hospital & facility affiliations
- Wellmont Bristol Regional Medical Center
- Wellmont Holston Valley Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 12 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 76 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD031443 | TN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | 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.
-
- Pulmonary Disease Physician
- Kingsport, TN
- NPI 1780986257
-
- Specialist
- Kingsport, TN
- NPI 1770578270
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.