Active NPI
Dimka M Ialamova-Tountcheva, MD
- Internal Medicine Physician
- Johnson City, TN
National Provider Identifier
1316924665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 39331
- Practice address
- 119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998 - Phone
- (423) 282-1480
- Fax
- (423) 928-1353
- NPI assigned
- Dec 28, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 39331 | TN | |
| Internal Medicine Physician | 207R00000X | 39331 | TN | Primary |
Addresses
Primary practice location
119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Mailing address
119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Phone (423) 282-1480
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4122136 | Other | TN | BCBST |
| 3325769 | Medicaid | TN | |
| TN0101 | Other | TN | JOHN DEERE HEALTHCARE |
| P00334011 | Other | TN | RR MEDICARE |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39331 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Internal Medicine | Current | Accepting new patients |
| Inpatient Medical Services, PC | Hospitalist | Past | Accepting new patients |
Locations
2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Organizations & group practices 2
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.
-
- Hospitalist Physician
- Oak Ridge, TN
- NPI 1083835441
Internal Medicine
-
- Hospitalist Physician
- Johnson City, TN
- NPI 1316925191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1316924665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 BOONE RIDGE DR",
"address_2": "SUITE 201",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376154998",
"telephone_number": "423-282-1480",
"fax_number": "423-928-1353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 BOONE RIDGE DR",
"address_2": "SUITE 201",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376154998",
"telephone_number": "423-282-1480",
"fax_number": "423-928-1353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IALAMOVA-TOUNTCHEVA",
"first_name": "DIMKA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-28",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "TN",
"license": "39331",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "39331",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "4122136",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3325769",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE HEALTHCARE",
"identifier": "TN0101",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00334011",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.