NPIMap

Individual provider Active NPI

Rory D Justo, M.D.

  • Internal Medicine Physician
  • Kimball, TN
National Provider Identifier
1639160203
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD31741 Issued in TN
Practice address
24 Mountain View Dr
Kimball, TN 37347-5477
Phone
(423) 942-9171
Fax
(423) 942-9128
NPI assigned
Nov 2, 2005
Last updated
Jan 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD31741 TN Primary

Addresses

Primary practice location

24 Mountain View Dr
Kimball, TN 37347-5477

Mailing address

24 Mountain View Dr
Kimball, TN 37347-5477
Phone (423) 942-9171

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
I20031117000332 TN Practitioner - Internal Medicine 4183538994 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sequatchie Valley Primary CareGroup PAC ID 7810164050, 5 clinicians

Practice addresses (Care Compare)

24 Mountain View Dr
Suite a
Kimball, TN 37347-5478
Phone (423) 942-9171

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD31741TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Internal Medicine CurrentSince Mar 1, 2011 Accepting new patients
Sequatchie Valley Primary Care CurrentSince Jan 1, 2012 Accepting new patients
Emergency Medicine Services of TN, PC CurrentSince Apr 1, 2023 Accepting new patients
Hospital Medicine Services of TN, LLC CurrentSince Apr 1, 2023 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

2200 Morris Hill Rd
Chattanooga, TN 37421
Phone (423) 648-9290

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500

24 Mountain View Dr
Ste A
Kimball, TN 37347
Phone (423) 942-9171

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

2300 Patterson St
#M
Nashville, TN 37203

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1639160203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MOUNTAIN VIEW DR",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "373475477",
            "telephone_number": "423-942-9171",
            "fax_number": "423-942-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MOUNTAIN VIEW DR",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "373475477",
            "telephone_number": "423-942-9171",
            "fax_number": "423-942-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTO",
        "first_name": "RORY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD31741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimball, TN

Sources for this page

Verify at the official NPI Registry.