Individual provider Active NPI

Manoj Srinath, MD

  • Gastroenterology Physician
  • Bristol, TN
National Provider Identifier
1356344402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD 35088 Issued in TN
Practice address
235 Medical Park Blvd
Bristol, TN 37620-7455
Phone
(423) 274-6350
Fax
(423) 274-6354
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 035088 TN
Gastroenterology Physician 207RG0100X 0101230824 VA
Gastroenterology Physician 207RG0100X MD 35088 TN Primary

Addresses

Primary practice location

235 Medical Park Blvd
Bristol, TN 37620-7455

Mailing address

135 W Ravine Rd Ste 3-a
Kingsport, TN 37660-3847
Phone (423) 246-6777

Other practice location 1

240 Medical Park Blvd
Ste 3700
Bristol, TN 37620-7350
Phone (423) 990-2426

Other identifiers 3

IdentifierTypeStateIssuer
5856531MedicaidVA
3700035MedicaidTN
3862641MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100823000015 TN Practitioner - Gastroenterology 9436283751 Reassigns benefits to 1 organization
I20110812000250 VA Practitioner - Gastroenterology 9436283751

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology AssociatesGroup PAC ID 4789781048, 26 clinicians

Practice addresses (Care Compare)

235 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-6350

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
  • Russell County Hospital Hospital, Lebanon, VA, CCN 490002
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Smyth County Community Hospital Hospital, Marion, VA, CCN 490038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy118
Upper gastrointestinal (GI) endoscopy for acid reflux135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035088TNMDGastroenterology Physician
0101230824VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates Current Accepting new patients

Locations

135 W Ravine Rd
Ste 3-A
Kingsport, TN 37660
Phone (423) 246-6777

1980 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

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 7

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356344402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD STE 3-A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-246-6777",
            "fax_number": "423-246-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207455",
            "telephone_number": "423-274-6350",
            "fax_number": "423-274-6354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Medical Park Blvd",
            "address_2": "Ste 3700",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207350",
            "country_code": "US",
            "telephone_number": "423-990-2426",
            "fax_number": "423-990-2407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRINATH",
        "first_name": "MANOJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "035088",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101230824",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD 35088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5856531",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700035",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3862641",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.