Individual provider Active NPI

Bruce S Grover, M.D.

  • Pulmonary Disease Physician
  • Kingsport, TN
National Provider Identifier
1518919745
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
21113 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone
(423) 224-4000
NPI assigned
May 16, 2006
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 21113 TN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101233245 VA
Pulmonary Disease Physician 207RP1001X 0101233245 VA
Pulmonary Disease Physician 207RP1001X 21113 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

111 W Stone Dr
Suite 100
Kingsport, TN 37660-6027
Phone (423) 247-5197

Other practice location 2

16000 Johnston Memorial Dr Ste 312D
Abingdon, VA 24211-7664
Phone (276) 258-1000

Other practice location 3

400 N State Of Franklin Rd Rm 2746
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other practice location 4

743 Island Rd
Bristol, VA 24201-7403
Phone (276) 469-4200

Other practice location 5

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other practice location 6

1980 Holton Ave E Ste 204
Big Stone Gap, VA 24219-3367
Phone (276) 764-0987

Other practice location 7

851 Locust St
Rogersville, TN 37857-2407
Phone (423) 921-7000

Other practice location 8

2000 Brookside Dr Fl 7
Kingsport, TN 37660-4627
Phone (423) 857-7000

Other identifiers 11

IdentifierTypeStateIssuer
100024532OtherTNPHP TENN CARE
0139819OtherTNBLUE CROSS BLUE SHIELD
1737428OtherTNUNITED HEALTHCARE
4604190OtherTNAETNA
Z101OtherTNUNITED HEALTHCARE OF THE RIVER VALLEY
030474OtherVAANTHEM
3061311MedicaidTN
006044182OtherVAVIRGINIA MEDICAID
1000908MedicaidTN
62134825606OtherTNJOHN DEERE HEALTHCARE
64911787OtherKYKENTUCKY MEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070504000408 TN Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8729055777 Reassigns benefits to 2 organizations
I20080612000762 VA Practitioner - Pulmonary Disease 8729055777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, shared by 2 NPIs, 432 clinicians
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, shared by 2 NPIs, 283 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200

16000 Johnston Memorial Dr
312D
Abingdon, VA 24211-7664
Phone (276) 258-1740

400 N State of Franklin Rd
RM 2746
Johnson City, TN 37604-6035
Phone (423) 431-2727

619 W Main St
Lebanon, VA 24266-3809
Phone (276) 415-9160

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Critical Care Medicine CurrentSince Nov 1, 2024 Accepting new patients
Wellmont Medical Associates Inc Pulmonary Disease Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jun 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jun 1, 2022 Accepting new patients
Pulmonary Associates of Kingsport Past Accepting new patients
Kingsport Bronchoscopy Center, Inc. Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

115 Judge Gresham Rd
Ste A
Gray, TN 37615
Phone (423) 467-3000

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

400 N State of Franklin Rd
Rm 2746
Johnson City, TN 37604
Phone (423) 431-2727

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2000 Brookside Dr
Fl 7
Kingsport, TN 37660
Phone (423) 857-7011

2050 Meadowview Pkwy
Ste 204
Kingsport, TN 37660
Phone (423) 247-9075

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

16000 Johnston Memorial Dr
#312D
Abingdon, VA 24211
Phone (276) 258-1740

16000 Johnston Memorial Dr
Ste 312D
Abingdon, VA 24211
Phone (276) 258-1000

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1980 Holton Ave E
Ste 204
Big Stone Gap, VA 24219
Phone (276) 523-8703

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

743 Island Rd
Bristol, VA 24201
Phone (276) 469-4200

619 W Main St
Lebanon, VA 24266
Phone (276) 258-3740

565 Radio Hill Rd
Marion, VA 24354
Phone (276) 782-1234

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1518919745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Stone Dr",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606027",
            "country_code": "US",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr Ste 312D",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd Rm 2746",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Island Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242017403",
            "country_code": "US",
            "telephone_number": "276-469-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Judge Gresham Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376156213",
            "country_code": "US",
            "telephone_number": "423-467-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1980 Holton Ave E Ste 204",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193367",
            "country_code": "US",
            "telephone_number": "276-764-0987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 Locust St",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "TN",
            "postal_code": "378572407",
            "country_code": "US",
            "telephone_number": "423-921-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr Fl 7",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVER",
        "first_name": "BRUCE",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "21113",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101233245",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101233245",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "21113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENN CARE",
            "identifier": "100024532",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0139819",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1737428",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4604190",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF THE RIVER VALLEY",
            "identifier": "Z101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "030474",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3061311",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAID",
            "identifier": "006044182",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000908",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTHCARE",
            "identifier": "62134825606",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "64911787",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.