James Richard Risney, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

PA0000000411 Issued in TN

Practice address

1021 W Oakland Ave
Suite 102
Johnson City, TN 37604-2191

Phone

(423) 928-9014

Fax

(423) 928-3559

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Dermatolgy & Dermatologic Surgery PC

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1427128511
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1639160815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE",
            "address_2": "SUITE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042191",
            "telephone_number": "423-928-9014",
            "fax_number": "423-928-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE",
            "address_2": "SUITE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042191",
            "telephone_number": "423-928-9014",
            "fax_number": "423-928-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISNEY",
        "first_name": "JAMES",
        "middle_name": "RICHARD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "PA0000000411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3701830",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTHCARE",
            "identifier": "TN0104",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine M. Rigsby, APN
• Phillip J Riley, DPM
• Whitney W Riner, FNP-C, PMHNP-BC
• Alexander Jacob Risenhoover, DO
• Rising Spirit LLC
• Madonna Samuel Riyad
• Roan Drug Company LLC
• Roan Drug Company LLC
• Lydia Pipes Roane, LCSW
• Amanda R Roark, CRNA

• Dermatology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.