Patrick H Spivey III, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

16219 Issued in TN

Practice address

130 W Ravine Rd
Kingsport, TN 37660-3810

Phone

(423) 224-4000

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Care Physicians, Inc.

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1669410304

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1356385447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 MAIN ST",
            "address_2": "THIRD FLOOR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012032",
            "telephone_number": "814-539-5724",
            "fax_number": "814-536-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603810",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "PATRICK",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "16219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014486",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100141340",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510103",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David A. Sparks, M.D.
• Specialty Respiratory Services, LLC
• Specks 'N Shades Vision Center Inc.
• Gina Spence-Brown, FNP
• Andrew P. Spillett, M.D.
• Rebecca Miller Spivey, PHARMD
• Spring Oak Kingsport LLC
• Douglas J Springer, M.D
• Kristin Danielle Sproles, BCBA
• James Alexander Stakias, DDS

• All providers in Kingsport, TN
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.