Active NPI
Charles R Bice Jr., MD
- Ophthalmology Physician
- Kingsport, TN
National Provider Identifier
1477572238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 0000008499
- Practice address
- 135 W Ravine Rd
Suite 2C
Kingsport, TN 37660-3847 - Phone
- (423) 246-7372
- Fax
- (423) 578-4369
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 0000008499 | TN | Primary |
Addresses
Primary practice location
135 W Ravine Rd
Suite 2C
Kingsport, TN 37660-3847
Mailing address
135 W Ravine Rd
Suite 2C
Kingsport, TN 37660-3847
Phone (423) 246-7372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3163556 | Medicaid | TN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101111000263 | TN | Practitioner - Ophthalmology | 1557263761 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000008499 | TN | MD | Ophthalmology Physician |
| 662 | TN | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477572238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 W RAVINE RD",
"address_2": "SUITE 2C",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603847",
"telephone_number": "423-246-7372",
"fax_number": "423-578-4369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 W RAVINE RD",
"address_2": "SUITE 2C",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603847",
"telephone_number": "423-246-7372",
"fax_number": "423-578-4369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BICE",
"first_name": "CHARLES",
"middle_name": "R",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TN",
"license": "0000008499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3163556",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.