Individual provider Active NPI

Caleb Charles Osborne, MD

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1467949529
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
65030 Issued in TN
Practice address
917 W Walnut St
Johnson City, TN 37604-6527
Phone
(423) 439-6464
NPI assigned
Apr 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 65030 TN Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 65030 TN

Addresses

Primary practice location

917 W Walnut St
Johnson City, TN 37604-6527

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

Other practice location 2

208 Medical Park Blvd
Bristol, TN 37620
Phone (423) 989-4050

Other identifiers 1

IdentifierTypeStateIssuer
Q041980MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220714003307 TN Practitioner - Family PracticePractitioner - Addiction Medicine 6901159607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

917 W Walnut St
Johnson City, TN 37604-6527
Phone (423) 439-6464

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Medical Education Assistance Corporation Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Health System Current Accepting new patients
Medical Education Assistance Corporation Family Medicine Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

408 N State of Franklin Rd
Ste 31A
Johnson City, TN 37604
Phone (423) 431-4946

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

2 Professional Park Dr
Ste 11
Johnson City, TN 37604
Phone (423) 434-0642

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

Interoperability endpoints

  • Direct secure messaging: cosborne123604@balladhealth.medalliesdirect.net

Organizations & group practices 6

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 3

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": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1467949529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046527",
            "telephone_number": "423-439-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "37660",
            "country_code": "US",
            "telephone_number": "423-245-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "37620",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "CALEB",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-15",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "65030",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "TN",
            "license": "65030",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q041980",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.