Individual provider Active NPI

Anthony J Palazzo, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Johnson City, TN
National Provider Identifier
1629030267
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
43661 Issued in TN
Practice address
310 N State of Franklin Rd
Suite 101
Johnson City, TN 37604-6008
Phone
(423) 929-7393
Fax
(423) 929-0872
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 43661 TN Primary

Addresses

Primary practice location

310 N State of Franklin Rd
Suite 101
Johnson City, TN 37604-6008

Mailing address

310 N State of Franklin Rd
Suite 101
Johnson City, TN 37604-6008
Phone (423) 929-7393

Other identifiers 6

IdentifierTypeStateIssuer
7100051410MedicaidKY
1506079MedicaidTN
P00677077OtherSDRAILROAD MEDICARE
4190101OtherTNBC/BS
5910847MedicaidNC
1629030267MedicaidVA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080731000786 TN Practitioner - Thoracic Surgery 7517933138 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Louisiana State University School of Medicine in Shreveport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

271 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-8600

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43661TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Nov 7, 2021 Accepting new patients
Wellmont Medical Associates Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Nov 7, 2021 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Aug 1, 2008 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Cardiology Services Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Nov 7, 2021 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Aug 1, 2008 Accepting new patients
Mountain States Health Alliance Past Accepting new patients
Johnston Memorial Hospital, Inc PastSince Jul 1, 2013 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

310 N State of Franklin Rd
Ste 101
Johnson City, TN 37604
Phone (423) 929-7393

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

2050 Meadowview Pkwy
Kingsport, TN 37660

Organizations & group practices 9

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1629030267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-929-7393",
            "fax_number": "423-929-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046008",
            "telephone_number": "423-929-7393",
            "fax_number": "423-929-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "43661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100051410",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506079",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00677077",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4190101",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910847",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629030267",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.