Individual provider Active NPI

Alan H Pugh, M.D.

  • Anesthesiology Physician
  • Johnson City, TN
National Provider Identifier
1376542258
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD0000015175 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604
Phone
(423) 431-6111
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000015175TNMDAnesthesiology Physician

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD0000015175 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604

Mailing address

1009 Lark St Ste 2
Johnson City, TN 37604-8218
Phone (423) 283-0776

Other practice location 1

1009 Lark St
Suite 2
Johnson City, TN 37604-8217
Phone (423) 283-0776 ext. 108

Other practice location 2

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300

Other practice location 3

601 Med Tech Pkwy
Johnson City, TN 37604-2253
Phone (423) 610-1020

Other practice location 4

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Other practice location 5

2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3019582MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 22, 2019.

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1376542258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 LARK ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048218",
            "telephone_number": "423-283-0776",
            "fax_number": "423-283-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-431-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 Lark St",
            "address_2": "SUITE 2",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376048217",
            "country_code": "US",
            "telephone_number": "423-283-0776 x108",
            "fax_number": "423-283-0549",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 W Elk Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432874",
            "country_code": "US",
            "telephone_number": "423-542-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042253",
            "country_code": "US",
            "telephone_number": "423-610-1020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Med Tech Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042277",
            "country_code": "US",
            "telephone_number": "423-302-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "ALAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "MD0000015175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019582",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.