Individual provider Active NPI

Randall L Belt, D.O.

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1265475321
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1640 Issued in TN
Practice address
378 Marketplace Dr
Suite 5
Johnson City, TN 37604-2361
Phone
(423) 282-0751
Fax
(423) 282-1577
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 11

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Regional Emergency Physicians, PC 118 clinicians

Practice addresses (Care Compare)

1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000

Hospital & facility affiliations

  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
83.8
Improvement activities
40

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050225000263 TN Practitioner - Emergency Medicine 9436131141 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1640TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Jun 25, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 17, 2016 Accepting new patients
St. Luke'S Princeton LLC Past Accepting new patients
Logan General Hospital LLC Family Medicine Past Accepting new patients
Epmg of Virginia P C Past Accepting new patients
Wellmont Medical Associates, Inc. Past Accepting new patients
Elm Emergency Group PLLC Emergency Medicine Past Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients
Wellmont Medical Associates, Inc. Past Accepting new patients
National Emergency Services West Virginia Inc Emergency Medicine Past Accepting new patients
Watauga Pathology Associates PC Past Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

2000 Brookside Dr
Kingsport, TN 37660
Phone (423) 857-7144

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1640 TN
Emergency Medicine Physician 207P00000X 1756 WV
Family Medicine Physician 207Q00000X 1640 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

378 Marketplace Dr
Suite 5
Johnson City, TN 37604-2361

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Other practice location 1

1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000

Other identifiers 5

NPPES NPI Registry
IdentifierTypeStateIssuer
5600582001MedicaidWV
P00285995OtherWVMEDICARE RAILROAD
000688219OtherWVBLUE CROSS
005645786MedicaidVA
6405640MedicaidKY

Other names 1

NPPES NPI Registry
  • Dr. Randall Lee Belt Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 7, 2021.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1265475321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-224-3250",
            "fax_number": "423-224-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 MARKETPLACE DR",
            "address_2": "SUITE 5",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042361",
            "telephone_number": "423-282-0751",
            "fax_number": "423-282-1577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454279",
            "country_code": "US",
            "telephone_number": "423-787-5000",
            "fax_number": "423-787-5083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELT",
        "first_name": "RANDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1640",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1756",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5600582001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00285995",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000688219",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005645786",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6405640",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDALL",
            "last_name": "BELT",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.