Individual provider Active NPI

Charles R Bice Jr., MD

  • Ophthalmology Physician
  • Kingsport, TN
National Provider Identifier
1477572238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0000008499 Issued in TN
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3163556MedicaidTN

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
I20101111000263 TN Practitioner - OphthalmologyPractitioner - Optometry 1557263761

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000008499TNMDOphthalmology Physician
662TNMDStudent 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

Verify at the official NPI Registry.