John J Bandeian Jr., MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

37131 Issued in MA

Practice address

3169 W State St
Bristol, TN 37620-1610

Phone

(423) 968-3891

NPI assigned

Jun 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306886841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201610",
            "telephone_number": "423-968-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201610",
            "telephone_number": "423-968-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDEIAN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "37131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Nicole Baker, RBT
• Stephan Allen Ball, PT, DPT, ATC
• Shannon Rae Balthazr, PTA
• Tracy Lynn Bamman, CPHT
• Rohan Banan, MD
• Savanna Marie Barber, PA-C
• Linda J Barger, APRN BC
• Randall F. Barker, M.D.
• Michael B Baron, MD
• Jamie Lynn Barr, BSW

• Plastic Surgery Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Plastic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.