Individual provider Active NPI

Julia Erin Reid, M.D.

  • Dermatology Physician
  • Kingsport, TN
National Provider Identifier
1295927721
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
125-053205 Issued in IL
Practice address
2300 W Stone Dr
Kingsport, TN 37660-2360
Phone
(423) 246-4961
Fax
(423) 245-3136
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 036-127825 IL
Dermatology Physician 207N00000X 125-053205 IL Primary

Addresses

Primary practice location

2300 W Stone Dr
Kingsport, TN 37660-2360

Mailing address

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

Other identifiers 2

IdentifierTypeStateIssuer
036127825MedicaidIL
1295927721MedicaidVA

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
I20120813000605 TN Practitioner - Dermatology 7214115245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Kentucky College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates, P.C.Group PAC ID 3971578816, 26 clinicians

Practice addresses (Care Compare)

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision75
Removal of skin lesions102
Removal of skin cancer539
Skin biopsy37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-053205ILMDDermatology Physician
036-127825ILMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, P.C. Dermatology CurrentSince Sep 1, 2012 Accepting new patients

Locations

3183 W State St
Ste 1102
Bristol, TN 37620
Phone (423) 764-7131

3183 W State St
Bristol, TN 37620
Phone (423) 764-7131

2885 Boones Creek Rd
Johnson City, TN 37615
Phone (423) 928-9014

2300 W Stone Dr
Kingsport, TN 37660
Phone (423) 246-4961

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 1

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": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1295927721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "JULIA",
        "middle_name": "ERIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036-127825",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125-053205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036127825",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295927721",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.