Active NPI
Brian Scott Wakefield, M.D.
- Pediatrics Physician
- Johnson City, TN
National Provider Identifier
1598059164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 51565
- Practice address
- 401 E Main St
Johnson City, TN 37601-4877 - Phone
- (423) 929-2584
- Fax
- (423) 722-2060
- NPI assigned
- Jun 1, 2011
- Last updated
- Aug 1, 2014
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 51565 | TN | Primary |
Addresses
Primary practice location
401 E Main St
Johnson City, TN 37601-4877
Mailing address
401 E Main St
Johnson City, TN 37601-4877
Phone (423) 929-2584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51565 | Other | TN | MEDICAL LICENSE |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51565 | TN | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Care PLLC | Current | Accepting new patients |
Locations
401 E Main St
Johnson City, TN 37601
Phone (423) 722-2062
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.
-
- Family Medicine Physician
- Elizabethton, TN
- NPI 1851537260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406851200000",
"number": "1598059164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376014877",
"telephone_number": "423-929-2584",
"fax_number": "423-722-2060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E MAIN ST",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376014877",
"telephone_number": "423-929-2584",
"fax_number": "423-722-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKEFIELD",
"first_name": "BRIAN",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-01",
"last_updated": "2014-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "51565",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "51565",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
- Robin M Wade, DPT
- Julia Wagner
- Mariah M Wagner, PA-C
- Mary Elizabeth Wagner, M.S., CCC-SLP
- Vonda Karla Wagner, MA
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1080)
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3829)
- Wal-Mart Stores East, LP (Wal-Mart Vision Center 30-3829)
- Wal-Mart Stores East, LP (Vision Center 30-1080)
- John M Waldron, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.