NPIMap

Individual provider Active NPI

Christopher S Shamblin, MD

  • Internal Medicine Physician
  • Sweetwater, TN
National Provider Identifier
1609954569
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD38965 Issued in TN
Practice address
304 Wright Street
Sweetwater, TN 37874-2823
Phone
(865) 213-8595
Fax
(865) 213-8373
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38965 TN
Internal Medicine Physician 207R00000X MD38965 TN Primary

Addresses

Primary practice location

304 Wright Street
Sweetwater, TN 37874-2823

Mailing address

304 Wright Street
Sweetwater, TN 37874-2823
Phone (865) 213-8595

Other identifiers 2

IdentifierTypeStateIssuer
4234294OtherTNBLUE CROSS BLUE SHIELD
1514793MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000094 TN Practitioner - Internal Medicine 4284607847 Reassigns benefits to 1 organization
Practice locations: Sweetwater, TN

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sweetwater Hospital Association 26 clinicians

Practice addresses (Care Compare)

304 Church St
Sweetwater, TN 37874-1181
Phone (865) 213-8401

Hospital & facility affiliations

  • Sweetwater Hosp Home Health Home health agency, Sweetwater, TN, CCN 447476
  • Sweetwater Hospital Association Hospital, Sweetwater, TN, CCN 440084
  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011
  • Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38965TNMDInternal Medicine Physician
MD38965TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetwater Hospital Association Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Sweetwater Hospital Association CurrentSince Oct 1, 2022 Accepting new patients
East Tennessee Medical Group, PC Internal Medicine Past Accepting new patients
Sweetwater Hospital Association Past Accepting new patients

Locations

304 Church St
Sweetwater, TN 37874
Phone (865) 213-8200

1255 Highway 411
Ste 6
Vonore, TN 37885
Phone (865) 213-8401

Organizations & group practices 6

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 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1609954569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WRIGHT STREET",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "378742823",
            "telephone_number": "865-213-8595",
            "fax_number": "865-213-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WRIGHT STREET",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "378742823",
            "telephone_number": "865-213-8595",
            "fax_number": "865-213-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "38965",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD38965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4234294",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514793",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sweetwater, TN

Sources for this page

Verify at the official NPI Registry.