NPIMap

Individual provider Active NPI

Gerardo Garcia, D.O

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1497082895
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0116022013 Issued in VA
Practice address
2000 Brookside Dr
3Rd Floor
Kingsport, TN 37660-4627
Phone
(423) 857-5905
Fax
(423) 857-5904
NPI assigned
Nov 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116022013 VA Primary
Internal Medicine Physician 207R00000X TP386 KY

Addresses

Primary practice location

2000 Brookside Dr
3Rd Floor
Kingsport, TN 37660-4627

Mailing address

2000 Brookside Dr
3Rd Floor
Kingsport, TN 37660-4627
Phone (423) 857-5905

Other identifiers 4

IdentifierTypeStateIssuer
P01200420OtherTNRAILROAD MEDICARE
Q000344MedicaidTN
1497082895MedicaidVA
7100238670MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161230001706 KY Practitioner - Internal Medicine 2365687324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-3161

Hospital & facility affiliations

  • Spring View Hospital Hospital, Lebanon, KY, CCN 180024
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0116022013VAMDInternal Medicine Physician
2415TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spring View Hospital LLC Past Accepting new patients

Organizations & group practices 2

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1497082895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 BROOKSIDE DR",
            "address_2": "3RD FLOOR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604627",
            "telephone_number": "423-857-5905",
            "fax_number": "423-857-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BROOKSIDE DR",
            "address_2": "3RD FLOOR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604627",
            "telephone_number": "423-857-5905",
            "fax_number": "423-857-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GERARDO",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-06",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116022013",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "TP386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01200420",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000344",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497082895",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100238670",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.