Individual provider Active NPI

Megan Paige Sutphin, PA-C

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1528608908
Registry record updated Jan 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
161 Heart Dr Ste a
Johnson City, TN 37604-2607
Phone
(703) 851-8564
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

161 Heart Dr Ste a
Johnson City, TN 37604-2607

Mailing address

161 Heart Dr Ste a
Johnson City, TN 37604-2607
Phone (703) 851-8564

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230530002491 TN Practitioner - Physician Assistant 1951724640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

161 Heart Dr
Johnson City, TN 37604-2607

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5367TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince May 1, 2023 Accepting new patients
Wellmont Health System Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince May 1, 2023 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince May 1, 2023 Accepting new patients
Blue Ridge Medical Management Corpoartion Physician Assistant CurrentSince May 1, 2023 Accepting new patients

Locations

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

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

161 Heart Dr
Ste A
Johnson City, TN 37604
Phone (423) 282-0751

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

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

Interoperability endpoints

  • Direct secure messaging: msutphin321450@balladhealth.medalliesdirect.net

Organizations & group practices 6

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 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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1528608908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 HEART DR STE A",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042607",
            "telephone_number": "703-851-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 HEART DR STE A",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042607",
            "telephone_number": "703-851-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTPHIN",
        "first_name": "MEGAN",
        "middle_name": "PAIGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.