Individual provider Active NPI

Jonathan Spencer Suther, M.D.

  • Diagnostic Radiology Physician
  • Kingsport, TN
National Provider Identifier
1568737666
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
57510 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone
(423) 968-1144
NPI assigned
Mar 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35920 AL
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 57510 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Mailing address

3053 W State St
Bristol, TN 37620-1720
Phone (423) 968-1144

Other practice location 1

2010 Brookwood Medical Ctr Dr
Birmingham, AL 35209-6804
Phone (877) 406-2916

Other identifiers 1

IdentifierTypeStateIssuer
Q044685MedicaidTN

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
I20181029001535 TN Practitioner - Diagnostic Radiology 6709028236 Reassigns benefits to 1 organization
I20201125001902 VA Practitioner - Diagnostic Radiology 6709028236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Carolina School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Radiology PCGroup PAC ID 7416860473, 77 clinicians

Practice addresses (Care Compare)

105 Fairlea CT
Lynchburg, VA 24503-2164
Phone (423) 968-1144

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 244-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35920ALMDDiagnostic Radiology Physician
57510TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Radiology, P.C. Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients

Locations

3053 W State St
Bristol, TN 37620
Phone (423) 301-6567

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

4289 Bonny Oaks Dr
Ste 106
Chattanooga, TN 37406

103 W Stone Dr
Kingsport, TN 37660
Phone (423) 224-4050

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

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1568737666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201720",
            "telephone_number": "423-968-1144"
        },
        {
            "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": "423-968-1144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2010 Brookwood Medical Ctr Dr",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352096804",
            "country_code": "US",
            "telephone_number": "877-406-2916",
            "fax_number": "334-794-0721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHER",
        "first_name": "JONATHAN",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "35920",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "57510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q044685",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.