Active NPI
Elizabeth Anne Defluiter, MD
- Surgery Physician
- Elizabethton, TN
National Provider Identifier
1255363347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD40285
- Practice address
- 1497 W Elk Ave
Suite 10
Elizabethton, TN 37643-2895 - Phone
- (423) 542-7440
- Fax
- (423) 542-7445
- NPI assigned
- Jul 7, 2006
- Last updated
- Aug 16, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD40285 | TN | Primary |
Addresses
Primary practice location
1497 W Elk Ave
Suite 10
Elizabethton, TN 37643-2895
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255363347 | Medicaid | VA | |
| P00978836 | Other | TN | RAILROAD MEDICARE |
| Q003381 | Medicaid | TN |
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
- General Surgery
- Education
- East Tennessee State University Quillen College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1497 W Elk Ave
Elizabethton, TN 37643-2896
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 13 |
| Hernia repair - groin (open) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD40285 | TN | MD | Surgery Physician |
| 40285 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management | Surgery | Current | Accepting new patients |
| Blue Ridge Medical Management Corporation | Past | Accepting new patients |
Locations
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba First Assist Urgent Care
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
-
dba Ballad Health Medical Associates
- Cardiovascular Disease Physician
- Johnson City, TN
- NPI 1740227131
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Woodridge Hospital
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
dba Sycamore Shoals Hospital
- General Acute Care Hospital
- Elizabethton, TN
- NPI 1891801734
-
dba Johnson City Medical Center
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
dba Johnson City Medical Center
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1255363347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-302-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1497 W ELK AVE",
"address_2": "SUITE 10",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376432895",
"telephone_number": "423-542-7440",
"fax_number": "423-542-7445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFLUITER",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "MD40285",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255363347",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00978836",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q003381",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.