Patrick Rene Showalter, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD0000036172 Issued in TN

Practice address

2204 Pavilion Dr Ste 310
Kingsport, TN 37660-4653

Phone

(423) 246-4155

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, HI, TX, NM4 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 4

Specialty

Urology

Education

Vanderbilt University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Cruces Physician Practices, LLCGroup PAC ID 7618974858, 107 clinicians

Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Los Alamos Physician Practices LLCGroup PAC ID 4587661541, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018
• Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014
• Los Alamos Medical Center Hospital, Los Alamos, NM, CCN 320033

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrick.showalter.1@19849.direct.athenahealth.com

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.

• Las Cruces Physician Practices, LLC

  dba NM Cardiovascualr Associates

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1093947491
  Medicare reassignment Care Compare group NPD
• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment Care Compare group
• Los Alamos Physician Practices LLC

  • Family Medicine Physician
  • Los Alamos, NM
  • NPI 1750330510
  Medicare reassignment Care Compare group
• Wellmont Medical Associates Inc

  dba Ballad Health Medical Associates

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment NPD
• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149
  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Las Cruces Physician Practices, LLC

  dba New Mexico Cardiac Care

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1346586195
  NPD
• Las Cruces Physician Practices, LLC

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1356390769
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• PHC-Las Cruces Inc

  dba Memorial Medical Center of Las Cruces

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1700821808
  Care Compare affiliation
• PHC-Los Alamos Inc

  dba Los Alamos Medical Center

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  Care Compare affiliation
• Wilcox Memorial Hospital

  • Rural Acute Care Hospital
  • Lihue, HI
  • NPI 1225113442
  Care Compare affiliation

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1558343830",
    "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": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR STE 310",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604653",
            "telephone_number": "423-246-4155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1747 Medical Center Pkwy",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292563",
            "country_code": "US",
            "telephone_number": "615-893-1600",
            "fax_number": "615-225-6887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "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"
        }
    ],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "PATRICK",
        "middle_name": "RENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD0000036172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3873348",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa L Shockley, MD
• Dallas Shone, MD
• Josh Shook, MD
• Ashley Nicole Shouse, FNP
• Michael Shouse
• Carolyn A Shuler, APN, CS
• Larry D Shuster, MD
• Joni Foard Sierocinski, PHARM.D., CDE
• Martha Denise Silmon
• Robert W Silmon Jr., MD

• Urology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.