Individual provider Active NPI

Melissa S Palazzo, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Johnson City, TN
National Provider Identifier
1740272020
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
43626 Issued in TN
Practice address
400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035
Phone
(423) 431-2390
Fax
(423) 431-6715
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 021636 LA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 43626 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035

Mailing address

400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035
Phone (423) 431-2390

Other identifiers 1

IdentifierTypeStateIssuer
1507621MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080923000337 TN Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 2365496940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists)
Education
University of Utah School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, 283 clinicians

Practice addresses (Care Compare)

1497 W Elk Ave
Elizabethton, TN 37643-2896

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4847

408 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4946

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021636LAMDSpecialist
43626TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Oct 1, 2008 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Oct 1, 2008 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Pulmonary & Critical Care Specialists, L.L.C. Specialist Past Accepting new patients
University of Utah Hospitals and Clinics Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

400 N State of Franklin Rd
Rm 2746
Johnson City, TN 37604
Phone (423) 431-2727

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

Organizations & group practices 5

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1740272020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "ROOM 2746",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-2390",
            "fax_number": "423-431-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "ROOM 2746",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-2390",
            "fax_number": "423-431-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAZZO",
        "first_name": "MELISSA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "021636",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "43626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507621",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.