Individual provider Active NPI

Richard Chernecky, MD

  • Gastroenterology Physician
  • Bristol, TN
National Provider Identifier
1437210341
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036150540 Issued in IL
Practice address
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone
(423) 844-1121
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036150540 IL Primary
Gastroenterology Physician 207RG0100X 20775 MS

Addresses

Primary practice location

1 Medical Park Blvd
Bristol, TN 37620-7430

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

2 Good Samaritan Way Ste 420
Mount Vernon, IL 62864-2478
Phone (618) 899-3500

Other practice location 2

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

Other identifiers 2

IdentifierTypeStateIssuer
000247002DMedicaidMS
3021100531OtherMSMEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address rchernecky327385@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL, IL, NC, MT5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20090513000584 GA Practitioner - Gastroenterology 2961551353 Reassigns benefits to 1 organization
I20180522001871 AL Practitioner - Gastroenterology 2961551353 Reassigns benefits to 1 organization
I20190905003281 IL Practitioner - Gastroenterology 2961551353 Reassigns benefits to 1 organization
I20210115001925 NC Practitioner - Gastroenterology 2961551353 Reassigns benefits to 1 organization
I20240207003889 MT Practitioner - Gastroenterology 2961551353 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021146GAMDPharmacist
036150540ILMDGastroenterology Physician
20775MSMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Jul 1, 2024 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Feb 1, 2024 Accepting new patients
DCH Provider Services, LLC CurrentSince Mar 3, 2018 Accepting new patients
RCHP Billings - Missoula LLC Current Accepting new patients
Archbold Medical Group, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Aug 22, 2019 Accepting new patients
DCH Provider Services, LLC CurrentSince Mar 3, 2018 Accepting new patients
NHCS Physicians Inc CurrentSince May 13, 2021 Accepting new patients
NHCS Physicians Inc CurrentSince May 13, 2021 Accepting new patients
Aga Professional Services, LLC Gastroenterology PastSince Sep 1, 2015 Accepting new patients

Locations

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2 Good Samaritan Way
Ste 420
Mount Vernon, IL 62864
Phone (618) 899-4000

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

Interoperability endpoints

  • Direct secure messaging: richardchernecky@dhc.allscriptsdirect.net
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/
  • Direct secure messaging: rchernecky327385@direct-ehr-ssmhc.com

Organizations & group practices 10

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1437210341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Good Samaritan Way Ste 420",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628642478",
            "country_code": "US",
            "telephone_number": "618-899-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERNECKY",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036150540",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "20775",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000247002D",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3021100531",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Good Samaritan Way Ste 420",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rchernecky327385@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rchernecky327385@direct-ehr-ssmhc.com",
            "address_1": "2 Good Samaritan Way Ste 420",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.