Active NPI
Mark Ainsley Innis, MD
- Emergency Medicine Physician
- Portsmouth, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 0101243430
- Practice address
- 3636 High St
Portsmouth, VA 23707-3236 - Phone
- (757) 398-2200
- Fax
- (757) 398-2359
- NPI assigned
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 248590 | NY | |
| Emergency Medicine Physician | 207P00000X | 01078891A | IN | |
| Emergency Medicine Physician | 207P00000X | 0101243430 | VA | Primary |
Addresses
Primary practice location
3636 High St
Portsmouth, VA 23707-3236
Mailing address
1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Phone (865) 985-7012
Other practice location 1
2200 N Section St
Sullivan, IN 47882-7523
Phone (812) 268-4311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740450220 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, NY, KY, IN, WV, SC, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 7
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080725000496 | VA | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 7 organizations |
| I20131112002048 | NY | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 3 organizations |
| I20170627000746 | KY | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 1 organization |
| I20170718003433 | IN | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 1 organization |
| I20201020001236 | WV | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 1 organization |
| I20201215000905 | SC | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 1 organization |
| I20250905000965 | NC | Practitioner - Emergency Medicine | 6800969601 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Ohio State University College of Medicine, 2004
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Ainsley Medical LLCInterfaith Emergency Medicine PC
Practice addresses (Care Compare)
1108 Main St
Danville, VA 24541-2940
Phone (434) 421-6180
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000
Hospital & facility affiliations
- Bon Secours Maryview Medical Center
- Sovah Health Danville
- Brookdale Hospital Medical Center
- Bon Secours Harbour View Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.6 of 100
- Quality
- 76.36
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01078891A | IN | MD | Emergency Medicine Physician |
| 248590 | NY | MD | Emergency Medicine Physician |
| 0101243430 | VA | MD | Emergency Medicine Physician |
Practice roles (23 of 27)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexandria Springfield Emergency Physicians PC | Emergency Medicine | Current | Accepting new patients |
| Interfaith Emergency Medicine, P.C. | Emergency Medicine | Current | Accepting new patients |
| Emergency Professionals of Indiana, P.C. | Emergency Medicine | Current | Accepting new patients |
| Ainsley Medical LLC | Current | Accepting new patients | |
| Virtualcare Medical Group PA | Current | Accepting new patients | |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Lake Spring Emergency Group, LLC | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Associates P.a., P.C. | Current | Accepting new patients | |
| Brookdale Hospital Medical Center | Current | Accepting new patients | |
| Western Virginia Regional Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| The Brookdale Hospital Medical Center | Current | Accepting new patients | |
| Emergency Medicine Physicians of Mecklenburg County, PLLC | Emergency Medicine | Current | Accepting new patients |
| Acs Primary Care Physicians - Southeast PC | Emergency Medicine | Current | Accepting new patients |
| Health Care Alliance, Inc. | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Associates, P.a.,P.C. | Current | Accepting new patients | |
| Alexandria Springfield Emergency Physicians PC | Emergency Medicine | Current | Accepting new patients |
| Jones and Jones Transport LLC | Current | Accepting new patients | |
| Emergency Care Services of New York, P.C. | Emergency Medicine | Current | Accepting new patients |
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
| Tidewater Emergency Medical Care, LTD. | Emergency Medicine | Current | Accepting new patients |
| New York City Health and Hospitals Corporation | Past | Accepting new patients | |
| Tidewater Emergency Medical Care | Past | Accepting new patients | |
| Emergency Coverage Services, PC | Past | Accepting new patients |
Locations (25 of 31)
3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021
2200 N Section St
Sullivan, IN 47882
Phone (812) 268-6292
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100
1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011
2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000
307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300
121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604
1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212
1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143
122 DeKalb Ave
Brooklyn, NY 11217
451 Clarkson Ave
#R
Brooklyn, NY 11203
Phone (718) 245-2306
1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175
301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166
809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182
1431 Centerpoint Blvd
Ste 100
Knoxville, TN 37932
Phone (865) 539-8000
1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111
736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124
60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100
1108 Main St
Danville, VA 24541
Phone (434) 421-6180
100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153
15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000
8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000
8260 Atlee Rd
Mechanicsvlle, VA 23116
Phone (804) 264-6000
100 15th St NW
Norton, VA 24273
Phone (276) 439-1000
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- mark.innis.1@30241.direct.athenahealth.com
Organizations & group practices 24
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.
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1457643785
Emergency Medicine, NY
-
- Emergency Medicine Physician
- Franklin, VA
- NPI 1740529700
Emergency Medicine, VA
-
- Emergency Medicine Physician
- Salem, VA
- NPI 1215429600
Emergency Medicine, VA
-
- Emergency Medicine Physician
- Chesapeake, VA
- NPI 1710991153
Emergency Medicine, VA
-
- Emergency Medicine Physician
- Norton, VA
- NPI 1386183028
Emergency Medicine, VA
-
- Emergency Medicine Physician
- Myrtle Beach, SC
- NPI 1861430555
Emergency Medicine, SC
-
- Emergency Medicine Physician
- Syracuse, NY
- NPI 1639236656
Emergency Medicine, NY
-
- Emergency Medicine Physician
- Charlotte, NC
- NPI 1912232182
Emergency Medicine, NC
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Martinsville, VA
- NPI 1386720183
Hospital
-
- Rural Acute Care Hospital
- Danville, VA
- NPI 1154419737
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1740450220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 CENTERPOINT BLVD",
"address_2": "SUITE 100",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379321984",
"telephone_number": "865-985-7012",
"fax_number": "865-985-7077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3636 HIGH ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237073236",
"telephone_number": "757-398-2200",
"fax_number": "757-398-2359"
}
],
"practiceLocations": [
{
"address_1": "2200 N Section St",
"address_purpose": "LOCATION",
"city": "Sullivan",
"state": "IN",
"postal_code": "478827523",
"country_code": "US",
"telephone_number": "812-268-4311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INNIS",
"first_name": "MARK",
"middle_name": "AINSLEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "248590",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01078891A",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": "0101243430",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1740450220",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
- In My Home Care Support Services LLC
- Inclusively Me
- Independent Living & Support Services
- Infinity Residential Serivces LLC
- Innervation,LLC
- Innovative Counseling Solutions PLLC
- Inspire You Counseling LLC
- Inspire. Empower. Change. Counseling & Consulting, LLC
- Inspired Counseling LLC
- Inspired Home Solutions, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.