The Endoscopy Center of Bristol

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0000000114 Issued in TN

Legal business name

THE ENDOSCOPY CENTER OF BRISTOL

Practice address

235 Medical Park Blvd
Bristol, TN 37620-7455

Phone

(423) 246-6777

Fax

(423) 246-7766

NPI assigned

Sep 12, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Mark Bartley, CPA

Title

Chief Administrative Officer

Phone

(423) 246-6777

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

The Endoscopy Center of BristolCCN 44C0001106

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua D Hall, M.D.

  • Gastroenterology Physician
  • Bristol, TN
  • NPI 1255452751
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1376538876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD",
            "address_2": "SUITE 3A",
            "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": "423-246-6777",
            "fax_number": "423-246-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ENDOSCOPY CENTER OF BRISTOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "BARTLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "423-246-6777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100036168",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3288515",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7603819",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007603819",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "004001475",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tennessee CVS Pharmacy LLC
• Tennessee CVS Pharmacy LLC
• Frederick W Terry, D.O.
• John Tester
• The Bone and Joint Center
• The Office of Daphane Miller, PLLC
• The Regional Eye Center, P.C.
• Abigail Thomas, OTR/L
• Jessie L Thomas, CRNA
• Timothy L Thomas, D.D.S.

• Ambulatory Surgical Clinic/Center in Bristol, TN
• Providers in Bristol, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.