Individual provider Active NPI

Dima Youssef, MD

  • Infectious Disease Physician
  • Johnson City, TN
National Provider Identifier
1245411255
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD 46702 Issued in TN
Practice address
615 N State of Franklin Rd
Johnson City, TN 37604-8209
Phone
(423) 930-8337
Fax
(423) 926-1049
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD 46702 TN Primary

Addresses

Primary practice location

615 N State of Franklin Rd
Johnson City, TN 37604-8209

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 930-8337

Other practice location 1

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 989-4050

Other practice location 2

105 W Park Dr Ste 2A
Kingsport, TN 37660-3805
Phone (423) 930-8337

Other identifiers 2

IdentifierTypeStateIssuer
1524621MedicaidTN
MD 46702OtherTNMEDICAL LICENSE

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
I20110706000496 TN Practitioner - Infectious DiseasePractitioner - Internal Medicine 2163600594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
East Tennessee State University Quillen College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

105 W Park Dr
Suite 2a
Kingsport, TN 37660-3805
Phone (423) 930-8337

615 N State of Franklin Rd
Johnson City, TN 37604-8209
Phone (423) 930-8337

BLDG 52 Lake Dr
Mountain Home, TN 37684-0001
Phone (423) 439-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 46702TNMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Infectious Disease CurrentSince Jun 5, 2011 Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

615 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 433-6039

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

105 W Park Dr
Ste 2A
Kingsport, TN 37660
Phone (423) 251-6702

Organizations & group practices 1

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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1245411255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-930-8337",
            "fax_number": "423-926-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048209",
            "telephone_number": "423-930-8337",
            "fax_number": "423-926-1049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 W Park Dr Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603805",
            "country_code": "US",
            "telephone_number": "423-930-8337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "DIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "MD 46702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524621",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD  46702",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.