Active NPI
The Endoscopy Center of Bristol
- Ambulatory Surgical Clinic/Center
- Bristol, TN
National Provider Identifier
1376538876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 0000000114
- 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
- Last updated
- May 4, 2009
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 0000000114 | TN | Primary |
Addresses
Primary practice location
235 Medical Park Blvd
Bristol, TN 37620-7455
Mailing address
135 W Ravine Rd
Suite 3a
Kingsport, TN 37660-3847
Phone (423) 246-6777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120210000289 | TN | Part B Supplier - Ambulatory Surgical Center | 1355508896 | Practice locations: Bristol, TN |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- The Endoscopy Center of Bristol
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0980234 | Endoscopy Center of Bristol LLC | Certificate of waiver | Nov 14, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gastroenterology Physician
- Bristol, TN
- NPI 1255452751
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Bristol, TN
- Tennessee CVS Pharmacy LLC (CVS Pharmacy #07714)
- Tennessee CVS Pharmacy LLC (CVS Pharmacy #03726)
- Frederick W Terry, D.O.
- John Tester
- The Bone and Joint Center
- The Office of Daphane Miller, PLLC (Tri-Cities Peace and Healing, PLLC)
- The Regional Eye Center, P.C. (The Regional Eye Center)
- Abigail Thomas, OTR/L
- Jessie L Thomas, CRNA
- Timothy L Thomas, D.D.S.
Sources for this page
- 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.