Individual provider Active NPI

Charles Aaron Ross, D.O.

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1306005137
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2271 Issued in TN
Practice address
1335 E Center St
Suite 1
Kingsport, TN 37664-2489
Phone
(423) 247-2263
Fax
(423) 434-0818
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2271 TN Primary

Addresses

Primary practice location

1335 E Center St
Suite 1
Kingsport, TN 37664-2489

Mailing address

320 Wynfield CT
Kingsport, TN 37663-2900
Phone (423) 247-2263

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
I20110715000579 TN Practitioner - Family Practice 7719155845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1335 E Ctr St
Suite 1
Kingsport, TN 37664-2489
Phone (423) 247-2263

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2271TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Family Medicine PLLC Family Medicine CurrentSince Oct 1, 2015 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
Summit Medical Group, PLLC CurrentSince Aug 18, 2023 Accepting new patients
Summit Medical Group, PLLC Family Medicine CurrentSince Aug 18, 2023 Accepting new patients

Locations

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

117 W Sevier Ave
Ste 100
Kingsport, TN 37660
Phone (423) 224-3300

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

1335 E Center St
Ste 1
Kingsport, TN 37664
Phone (423) 247-2263

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

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

Organizations & group practices 5

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1306005137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WYNFIELD CT",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632900",
            "telephone_number": "423-247-2263",
            "fax_number": "423-246-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 E CENTER ST",
            "address_2": "SUITE 1",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642489",
            "telephone_number": "423-247-2263",
            "fax_number": "423-434-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CHARLES",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "2271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.