Dustin L Bates, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000003166 Issued in TN

Practice address

11408 Kingston Pike Ste 400
Knoxville, TN 37934-3976

Phone

(865) 392-1888

Fax

(865) 392-1889

NPI assigned

Nov 15, 2010

Last updated

Jul 21, 2022By the provider in NPPES

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 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doc on Main Street Family Practice LLC

  • Family Medicine Physician
  • Robbinsville, NC
  • NPI 1467175877
  NPD (past)

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699076117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11408 KINGSTON PIKE STE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343976",
            "telephone_number": "865-392-1888",
            "fax_number": "865-392-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11408 KINGSTON PIKE STE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343976",
            "telephone_number": "865-392-1888",
            "fax_number": "865-392-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "DUSTIN",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000003166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "103I976498",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE PTAN",
            "identifier": "P01878527",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029343",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Bastian, PT
• Rodrigo Bastidas, MD
• Benjamin Batchelor, N.P.
• Ashley Bateman
• Lorie L Bateman, PA-C
• Princess Bates, RBT
• Sara Bates, BSW
• Eden Victoria Batista, MSW
• Bonnie Lee Batson, MS, CF-SLP
• Margaret A Batt, M.D.

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.