Individual provider Active NPI

Samuel B Hilton, DO

  • General Practice Physician
  • Kingsport, TN
National Provider Identifier
1407379746
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4634 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone
(423) 224-4000
NPI assigned
Jul 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 104 TN
General Practice Physician 208D00000X 4634 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Mailing address

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220703000116 TN Practitioner - Orthopedic SurgeryPractitioner - General Practice 8022495928 Reassigns benefits to 2 organizations
I20230421000118 GA Practitioner - Sports MedicinePractitioner - Osteopathic Manipulative Medicine 8022495928 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Physicians PLLC CurrentSince May 1, 2022 Accepting new patients
Ac Spine & Wellness Center LLC General Practice CurrentSince Jan 16, 2023 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Mar 30, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Aica Orthopedics, P.C. Past Accepting new patients

Locations

217 Scenic Hwy
Lawrenceville, GA 30046
Phone (770) 513-6565

2253 Northwest Pkwy SE
Marietta, GA 30067
Phone (678) 647-8692

9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: sam.hilton.p3@direct.aicaorthopedics.nextgenshare.com
  • Direct secure messaging: sam.hilton.p2@direct.aicaorthopedics.nextgenshare.com
  • Direct secure messaging: sam.hilton.p1@direct.aicaorthopedics.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407379746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILTON",
        "first_name": "SAMUEL",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "104",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.