Individual provider Active NPI

Emilee Grace Dishner, PA-C

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1659921294
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3975 Issued in TN
Practice address
2410 Susannah St
Johnson City, TN 37601-1748
Phone
(423) 282-9011
Fax
(423) 282-0035
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3975 TN Primary

Addresses

Primary practice location

2410 Susannah St
Johnson City, TN 37601-1748

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

875 Larry Neil Way
Kingsport, TN 37660-6368
Phone (423) 282-9011

Other practice location 2

410 N State Of Franklin Rd Ste 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

Other practice location 3

340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011

Other practice location 4

2412 Susannah St
Johnson City, TN 37601-1726
Phone (423) 282-9011

Other identifiers 1

IdentifierTypeStateIssuer
3975OtherTNSTATE OF TN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191217001725 TN Practitioner - Physician Assistant 4688008162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

410 N State of Franklin Rd
Suite 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

410 N State of Franklin Rd
Suite 140B
Johnson City, TN 37604-6971
Phone (423) 431-2460

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3975TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Dec 18, 2022 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Dec 18, 2022 Accepting new patients
Watauga Orthopaedics, PLC Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients
Watauga Orthopaedics PLC Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients
Wellmont Health System Current Accepting new patients
Blue Ridge Medical Management Corporation Physician Assistant Past Accepting new patients

Locations

340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011

2412 Susannah St
Johnson City, TN 37601
Phone (423) 282-8070

410 N State of Franklin Rd
Ste 140
Johnson City, TN 37604
Phone (423) 431-2460

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011

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

875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011

Interoperability endpoints

  • Direct secure messaging: edishner179919@balladhealth.medalliesdirect.net

Organizations & group practices 7

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 3

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": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1659921294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Larry Neil Way",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606368",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State Of Franklin Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2460",
            "fax_number": "423-431-2456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Steeles Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "37620",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2412 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011726",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISHNER",
        "first_name": "EMILEE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TN",
            "identifier": "3975",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.