Shelton Hager, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39196 Issued in TN

Practice address

105 W Stone Dr
Ste 3a
Kingsport, TN 37660-3256

Phone

(423) 392-6200

Fax

(423) 392-6593

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, VA2 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

Specialty

Family Practice

Education

Brody School of Medicine at East Carolina University, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422
• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Indian Path Community Hospital Hospital, Kingsport, TN, CCN 440176

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://fhir.holstonmedicalgroup.com/R4/open-R4
• Direct secure messaging: him@hmgpath.allscriptsdirect.net
• Direct secure messaging: sheltonhager@hmgpath.allscriptsdirect.net

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.

• Holston Medical Group PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1831110667

  VA

  Medicare reassignment Care Compare group NPD
• Holston Medical Group, PC

  • Durable Medical Equipment & Medical Supplies
  • Kingsport, TN
  • NPI 1073869442
  NPD (past)

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

• Comprehensive Home Healthcare Services LLC

  • Home Health Agency
  • Johnson City, TN
  • NPI 1942258769
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1992813240
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1407859796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066",
            "fax_number": "423-857-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "STE 3A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603256",
            "telephone_number": "423-392-6200",
            "fax_number": "423-392-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "SHELTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "39196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10134706",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3325584",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@hmgpath.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "DM address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 W Stone Dr",
            "address_2": "Ste 3A",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376603256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Hadley
• Hagan Dentistry, P.L.L.C
• Andrew Ray Hagan, DMD
• Anna B Hagan, M.ED., ED.S.
• Ted W Hagen II, DMIN PHD
• Youngmee Hahn, CCC-SLP
• Tara Lynn Hahner, RA
• Meredith Brooke Hale
• Brandy Nicole Hall
• Coba Lanna Hall, FNP-BC

• Family Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.