Active NPI
Alan G Carnell, M.D.
- Gastroenterology Physician
- Bristol, TN
National Provider Identifier
1548255649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD034214
- Practice address
- 235 Medical Park Blvd
Bristol, TN 37620-7455 - Phone
- (423) 246-6777
- Fax
- (423) 246-7766
- NPI assigned
- Sep 14, 2005
- Last updated
- May 27, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD034214 | TN | Primary |
Addresses
Primary practice location
235 Medical Park Blvd
Bristol, TN 37620-7455
Mailing address
135 W Ravine Rd
Suite 3a
Kingsport, TN 37660-3847
Phone (423) 246-6777
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100033089 | Other | TN | PHP TENNCARE |
| 4122548 | Other | TN | AETNA |
| 1803867000 | Medicaid | WV | |
| 3700035 | Medicaid | TN | |
| 64062060 | Medicaid | KY | |
| 005853168 | Medicaid | VA | |
| 3149322 | Other | TN | BCBS OF TN |
| 381180 | Other | VA | ANTHEM |
| TN0115 | Other | TN | UNITED HEALTHCARE RIVER V |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD034214 | TN | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastroenterology Associates | Current | Accepting new patients |
Locations
135 W Ravine Rd
Ste 3-A
Kingsport, TN 37660
Phone (423) 246-6777
Organizations & group practices 1
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.
-
- Specialist
- Kingsport, TN
- NPI 1770578270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1548255649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 W RAVINE RD",
"address_2": "SUITE 3A",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603847",
"telephone_number": "423-246-6777",
"fax_number": "423-246-7766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 MEDICAL PARK BLVD",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376207455",
"telephone_number": "423-246-6777",
"fax_number": "423-246-7766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNELL",
"first_name": "ALAN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TN",
"license": "MD034214",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP TENNCARE",
"identifier": "100033089",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4122548",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1803867000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3700035",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64062060",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005853168",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TN",
"identifier": "3149322",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "381180",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE RIVER V",
"identifier": "TN0115",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bristol, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.