Kenneth E. Cutshall, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD19352 Issued in TN

Practice address

2 Professional Park Dr Ste 11
Johnson City, TN 37604-6584

Phone

(423) 975-5650

Fax

(423) 975-5652

NPI assigned

Sep 23, 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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Tennessee, HSC, College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Surgical Associates PLLCGroup PAC ID 1254224181, 61 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

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.

• Premier Surgical Associates, PLLC

  • Surgery Physician
  • Knoxville, TN
  • NPI 1750449443
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• Blue Ridge Medical Managgement Corporation

  • Internal Medicine Physician
  • Kingsport, TN
  • NPI 1649518309
  NPD
• Premier Surgical Associates, PLLC

  • Prosthetic/Orthotic Supplier
  • Knoxville, TN
  • NPI 1285806919

  Surgery

  NPD
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1114033628
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1114033628
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Elizabethton, TN
  • NPI 1891801734
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1700872959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5700",
            "fax_number": "865-584-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PROFESSIONAL PARK DR STE 11",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046584",
            "telephone_number": "423-975-5650",
            "fax_number": "423-975-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTSHALL",
        "first_name": "KENNETH",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD19352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009403",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001652350001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaynia Monk Cunningham, PHARMD
• Cura Partners, LLC
• Noel P Curcio, D.O.
• Stephanie Jean Curde, RRT, CPFT
• Susan R Curde, FNP
• Lea Ann Marie Cutshall
• Michael Cutshall, MD
• Joanna Elizabeth Cyrier
• Kathryn Cyrus
• Hasan Daher, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.