Watauga Orthopaedics, PLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WATAUGA ORTHOPAEDICS, PLC

Practice address

340 Steeles Rd
Bristol, TN 37620

Phone

(423) 282-9011

NPI assigned

Oct 7, 2019

Last updated

Jun 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katherine Elizabeth Lyons

Title

Credentialing Specialist

Phone

(423) 282-9011

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Watauga Orthopaedics PLC

  • Orthopaedic Surgery Physician
  • Johnson City, TN
  • NPI 1245251404

  1456246479

  Same PAC ID
• Watauga Orthopaedics, PLC

  • Durable Medical Equipment & Medical Supplies
  • Kingsport, TN
  • NPI 1104125210

  1456246479

  Same PAC ID
• Watauga Orthopaedics, PLC

  • Durable Medical Equipment & Medical Supplies
  • Greeneville, TN
  • NPI 1730924192

  1456246479

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Watauga Orthopaedics PL4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Watauga Orthopaedics, PLC

  • Durable Medical Equipment & Medical Supplies
  • Kingsport, TN
  • NPI 1104125210
  NPD tax ID
• Watauga Orthopaedics, PLC

  • Durable Medical Equipment & Medical Supplies
  • Greeneville, TN
  • NPI 1730924192
  NPD tax ID
• Watauga Orthopaedics, PLC

  • Orthopaedic Surgery Physician
  • Abingdon, VA
  • NPI 1538080809
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc A Aiken, MD

  • Orthopaedic Surgery Physician
  • Johnson City, TN
  • NPI 1558327395
  NPD (past)
• Madison Oden

  • Physical Therapist
  • Greeneville, TN
  • NPI 1801627898
  NPD (past)

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1518508993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STEELES RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-282-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATAUGA ORTHOPAEDICS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "423-282-9011"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil D Wallen, M.D.
• Daniel T Walters, CRNA
• Judy Lynn Walton, NP
• Valerie A Waruszewski, PHD
• Karlee Payton Wasilewski, PHARMD
• Waters of Bristol a Rehabilitation & Nursing Center LLC
• Pamela Ora Watson, PTA
• Jonathan Michael Watts, M.D.
• Stephen Leon Wayne, MD
• Webb Dentistry

• Durable Medical Equipment & Medical Supplies in Bristol, TN
• Providers in Bristol, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.