Individual provider Active NPI

John Tester

  • Physician Assistant
  • Bristol, TN
National Provider Identifier
1396536660
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3053 W State St
Bristol, TN 37620-1720
Phone
(423) 968-1144
NPI assigned
May 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TN Primary

Addresses

Primary practice location

3053 W State St
Bristol, TN 37620-1720

Mailing address

3053 W State St
Bristol, TN 37620-1720
Phone (423) 968-1144

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260312001766 TN Practitioner - Physician Assistant 4789167248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Radiology PCGroup PAC ID 7416860473, 77 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-2200

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Radiology, P.C. CurrentSince Mar 1, 2026 Accepting new patients

Locations

3053 W State St
Bristol, TN 37620
Phone (423) 301-6567

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1396536660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201720",
            "telephone_number": "423-968-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3053 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201720",
            "telephone_number": "423-968-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTER",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.