Michael E Chupp, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0000055171 Issued in TN

Practice address

312 Mia Dr
Bristol, TN 37620-7246

Phone

(423) 366-6005

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1457367302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 MIA DR",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207246",
            "telephone_number": "423-366-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MIA DR",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207246",
            "telephone_number": "423-366-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUPP",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301060968",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "0000055171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457367302",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Marie Cheshire
• Tracey Chitwood, MPH OTR/L
• Charles H. Christ, D.D.S.
• Cody D Christian, DDS
• Christopher Carle, DDS, PC
• Michael Brandon Church, LPTA
• City of Bristol
• Gregory E Clarity, MD
• Jean Y Clark, NP
• Jonathan Clark, M.D.

• Surgery Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.