Individual provider Active NPI

Brian Andrew O'Neal, D.O. , MPH

  • Dermatology Physician
  • Kingsport, TN
National Provider Identifier
1639159494
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0102201119 Issued in VA
Practice address
2300 W Stone Dr
Kingsport, TN 37660-2360
Phone
(423) 246-4961
Fax
(423) 245-3136
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 4739 TN
Aerospace Medicine Physician 2083A0100X VA 0102201119 VA
Dermatology Physician 207N00000X 0102201119 VA Primary

Addresses

Primary practice location

2300 W Stone Dr
Kingsport, TN 37660-2360

Mailing address

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN2 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
I20180831001722 CA Practitioner - Dermatology 5890045413 Reassigns benefits to 1 organization
I20220413001723 TN Practitioner - Dermatology 5890045413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates, P.C.Group PAC ID 3971578816, 26 clinicians

Practice addresses (Care Compare)

2885 Boones Creek Rd
Johnson City, TN 37615-8002
Phone (423) 928-9014

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision81
Removal of skin lesions1094
Removal or shaving of skin growth18
Skin biopsy300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102201119VAMDDermatology Physician
VA 0102201119VAMDAerospace Medicine Physician
4739TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, P.C. Dermatology CurrentSince May 1, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Dermatology CurrentSince Jul 30, 2018 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 30, 2018 Accepting new patients

Locations

7862 El Cajon Blvd
La Mesa, CA 91942
Phone (619) 644-6401

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

8701 Cuyamaca St
Santee, CA 92071
Phone (619) 568-8025

3183 W State St
Ste 1102
Bristol, TN 37620
Phone (423) 764-7131

2885 Boones Creek Rd
Johnson City, TN 37615
Phone (423) 928-9014

2300 W Stone Dr
Kingsport, TN 37660
Phone (423) 246-4961

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1639159494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "BRIAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O. , MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "4739",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "VA 0102201119",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0102201119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.