Active NPI
Edwin McElroy Jr., MD
- Hematology & Oncology Physician
- Kingsport, TN
National Provider Identifier
1487621272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 34245
- Practice address
- 111 W Stone Dr
Suite 300
Kingsport, TN 37660-6027 - Phone
- (423) 224-3150
- Fax
- (423) 224-3169
- NPI assigned
- Mar 1, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 34245 | TN | Primary |
| Hematology & Oncology Physician | 207RH0003X | 0101226835 | VA |
Addresses
Primary practice location
111 W Stone Dr
Suite 300
Kingsport, TN 37660-6027
Mailing address
999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3851706 | Medicaid | TN | |
| 005845947 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Physician Services Inc | Hematology & Oncology | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Big Stone Gap, VA
- NPI 1619095403
Hematology & Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343347200000",
"number": "1487621272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 EXECUTIVE PARK BLVD",
"address_2": "SUITE 201",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604632",
"telephone_number": "423-224-3250",
"fax_number": "423-224-3258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W STONE DR",
"address_2": "SUITE 300",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376606027",
"telephone_number": "423-224-3150",
"fax_number": "423-224-3169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCELROY",
"first_name": "EDWIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2012-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TN",
"license": "34245",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "VA",
"license": "0101226835",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3851706",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005845947",
"state": "VA"
}
],
"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 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.