Denise S Sibley, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD20001 Issued in TN

Practice address

403 Princeton Rd
Suite 7
Johnson City, TN 37601-2056

Phone

(423) 283-0333

Fax

(423) 283-0518

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

No

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

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

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.

• Wellspring Healthcare, PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1821009747
  NPD (past) Authorized official

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1366480709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD",
            "address_2": "SUITE 7",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012056",
            "telephone_number": "423-283-0333",
            "fax_number": "423-283-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD",
            "address_2": "SUITE 7",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012056",
            "telephone_number": "423-283-0333",
            "fax_number": "423-283-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "DENISE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD20001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4054870",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3883716",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amberli Kyra Shupe, MA, NCC
• Muhammad S Shurbaji, MD
• Agostino Siaw
• Isabella Sibaja
• David A Sibley, M.D,
• Afreen N. Siddiqui, MD
• Badar Siddiqui, M.D.
• Shazib Ansar Siddiqui
• Brooke Elizabeth Sigmon
• Hanna Edith Sigmund, PHARMD

• Internal Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.

Verify at the official NPI Registry.