Individual provider Active NPI

John Boxberger, MD

  • Surgery Physician
  • Cleveland, TN
National Provider Identifier
1508429754
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
71660 Issued in TN
Practice address
2175 Chambliss Ave NW Ste D
Cleveland, TN 37311-3842
Phone
(423) 472-5423
Fax
(423) 476-5523
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 71660 TN Primary

Addresses

Primary practice location

2175 Chambliss Ave NW Ste D
Cleveland, TN 37311-3842

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5700

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
I20241017000298 TN Practitioner - General Surgery 9537691456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Surgical Associates PLLCGroup PAC ID 1254224181, 61 clinicians

Practice addresses (Care Compare)

2175 Chambliss Ave NW
Suite D
Cleveland, TN 37311-3842
Phone (423) 472-5423

Hospital & facility affiliations

  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71660TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgical Associates, PLLC Surgery CurrentSince Jun 28, 2024 Accepting new patients
Premier Surgical Associates, PLLC Surgery CurrentSince Jun 28, 2024 Accepting new patients

Locations

2175 Chambliss Ave NW
Ste D
Cleveland, TN 37311
Phone (423) 472-1140

9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1508429754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5700",
            "fax_number": "865-584-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 CHAMBLISS AVE NW STE D",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113842",
            "telephone_number": "423-472-5423",
            "fax_number": "423-476-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOXBERGER",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "71660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.