Individual provider Active NPI

Scott E Hubbard, CRNA

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
National Provider Identifier
1699768549
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10807 Issued in TN
Practice address
10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone
(423) 390-0451
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN0000096922 TN
Certified Registered Nurse Anesthetist 367500000X 10807 TN Primary

Addresses

Primary practice location

10415 Wallace Alley St
Kingsport, TN 37663-3936

Mailing address

10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 390-0451

Other identifiers 1

IdentifierTypeStateIssuer
3628726MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071010000762 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395831093 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians
Northeast Tennessee Anesthesia, PLLCGroup PAC ID 2163697996, 7 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

10461 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 279-1414

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10807TNMDNeurology Physician
RN0000096922TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Tennessee Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 26, 2021 Accepting new patients
Wellmont Medical Associates Inc Current Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Feb 23, 2025 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 29, 2014 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 29, 2014 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jun 1, 2019 Accepting new patients
Singing River Health System PastSince Feb 23, 2025 Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

350 Blountville Hwy
Ste 108
Bristol, TN 37620
Phone (423) 844-6120

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

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

10461 Wallace Alley St
Kingsport, TN 37663
Phone (423) 279-1400

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

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 1

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1699768549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000096922",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3628726",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.