Individual provider Active NPI

Cynthia McGlothlin, WHNP

  • Women's Health Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1477556397
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
144476 Issued in TN
Practice address
350 Steeles Rd
Bristol, TN 37620-9532
Phone
(423) 844-4925
Fax
(423) 844-4933
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 144476 TN Primary
Women's Health Nurse Practitioner 363LW0102X 0024165896 VA

Addresses

Primary practice location

350 Steeles Rd
Bristol, TN 37620-9532

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

Other identifiers 2

IdentifierTypeStateIssuer
010114497MedicaidVA
3499917MedicaidTN

Other names 1

  • Miss Cynthia Gross Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041101001076 TN Practitioner - Nurse Practitioner 8224090253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PC 239 clinicians

Practice addresses (Care Compare)

240 Medical Park Blvd
Suite 2700
Bristol, TN 37620-7352
Phone (423) 274-6365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
144476TNMDWomen's Health Nurse Practitioner
0024165896VAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC CurrentSince Apr 1, 2004 Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

350 Steeles Rd
Bristol, TN 37620
Phone (423) 844-4925

320 Bristol West Blvd
Ste 2C
Bristol, TN 37620
Phone (423) 844-1399

2204 Pavilion Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3900

1754 US Highway 23 North
Weber City, VA 24290
Phone (276) 386-5980

Interoperability endpoints

  • Direct secure messaging: cynthiamcglothlin@hmgpath.allscriptsdirect.net

Organizations & group practices 1

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1477556397",
    "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": "350 STEELES RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376209532",
            "telephone_number": "423-844-4925",
            "fax_number": "423-844-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHLIN",
        "first_name": "CYNTHIA",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "144476",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024165896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010114497",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3499917",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "GROSS",
            "prefix": "MISS",
            "credential": "WHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.