Individual provider Active NPI

Richard K McDavid, M.D.

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1508861774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26551 Issued in TN
Practice address
3114 Browns Mill Rd
Johnson City, TN 37604-1417
Phone
(423) 282-5611
Fax
(423) 282-5712
NPI assigned
Jun 15, 2005
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
Family Medicine Physician 207Q00000X 26551 TN Primary

Addresses

Primary practice location

3114 Browns Mill Rd
Johnson City, TN 37604-1417

Mailing address

3114 Browns Mill Rd
Johnson City, TN 37604-1417
Phone (423) 282-5611

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
I20040304000874 TN Practitioner - Family Practice 5597653303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26551TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Physicians, Inc. Past Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Jan 1, 1990 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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508861774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 BROWNS MILL RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041417",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 BROWNS MILL RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041417",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDAVID",
        "first_name": "RICHARD",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "26551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.