Active NPI
Michael K Patrick, M.D.
- Internal Medicine Physician
- Marion, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101221326
- Practice address
- 245 Medical Park Dr FL 2
Marion, VA 24354-1100 - Phone
- (276) 378-2026
- NPI assigned
- Jun 7, 2006
- Last updated
- Sep 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 52231 | TN | |
| Hospitalist Physician | 208M00000X | 0101221326 | VA | |
| Hospitalist Physician | 208M00000X | 52231 | TN | |
| Internal Medicine Physician | 207R00000X | 0101221326 | VA | Primary |
Addresses
Primary practice location
245 Medical Park Dr FL 2
Marion, VA 24354-1100
Mailing address
509 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2579
Phone (423) 302-6567
Other practice location 1
1 Medical Park Blvd Ste 255W
Bristol, TN 37620-7430
Phone (423) 844-5560
Other practice location 2
1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 523-3111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538109038 | Medicaid | VA | |
| 5645718 | Other | VA | AETNA |
| Q002846 | Medicaid | TN | |
| P01250891 | Other | VA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Past | Accepting new patients | |
| Carilion Healthcare Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Ballad Health Medical Associates
- Cardiovascular Disease Physician
- Marion, VA
- NPI 1326159567
-
- Durable Medical Equipment & Medical Supplies
- Blacksburg, VA
- NPI 1407667256
-
dba Ballad Health Medical Associates
- Cardiovascular Disease Physician
- Johnson City, TN
- NPI 1740227131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1538109038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 MED TECH PKWY STE 100",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042579",
"telephone_number": "423-302-6567",
"fax_number": "423-408-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 MEDICAL PARK DR FL 2",
"city": "MARION",
"state": "VA",
"postal_code": "243541100",
"telephone_number": "276-378-2026"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Park Blvd Ste 255W",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207430",
"country_code": "US",
"telephone_number": "423-844-5560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1990 Holton Ave E",
"address_purpose": "LOCATION",
"city": "Big Stone Gap",
"state": "VA",
"postal_code": "242193350",
"country_code": "US",
"telephone_number": "276-523-3111",
"fax_number": "276-523-8876",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATRICK",
"first_name": "MICHAEL",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "52231",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "VA",
"license": "0101221326",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "TN",
"license": "52231",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101221326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1538109038",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5645718",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q002846",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01250891",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marion, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.