Individual provider Active NPI

Mark Ainsley Innis, MD

  • Emergency Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1740450220
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101243430 Issued in VA
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

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1740450220MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY, KY, IN, WV, SC, NC7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
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 LLCGroup PAC ID 6204280597, 2 clinicians
Interfaith Emergency Medicine PCGroup PAC ID 7012186638, 32 clinicians

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 Hospital, Portsmouth, VA, CCN 490017
  • Sovah Health Danville Hospital, Danville, VA, CCN 490075
  • Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233
  • Bon Secours Harbour View Medical Center Hospital, Suffolk, VA, CCN 490148

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01078891AINMDEmergency Medicine Physician
248590NYMDEmergency Medicine Physician
0101243430VAMDEmergency Medicine Physician

Practice roles (23 of 27)

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 10, 2021 Accepting new patients
Interfaith Emergency Medicine, P.C. Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Ainsley Medical LLC CurrentSince Aug 12, 2024 Accepting new patients
Virtualcare Medical Group PA CurrentSince Sep 2, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Lake Spring Emergency Group, LLC Emergency Medicine CurrentSince Oct 30, 2022 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Feb 1, 2016 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Sep 11, 2019 Accepting new patients
Western Virginia Regional Emergency Physicians, LLC Emergency Medicine CurrentSince Nov 13, 2021 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Sep 11, 2019 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Health Care Alliance, Inc. Emergency Medicine CurrentSince Sep 12, 2020 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Feb 1, 2016 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Dec 10, 2021 Accepting new patients
Jones and Jones Transport LLC Current Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Mar 1, 2021 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Apr 1, 2012 Accepting new patients
Tidewater Emergency Medical Care, LTD. Emergency Medicine CurrentSince Feb 1, 2017 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
Tidewater Emergency Medical Care PastSince Feb 2, 2020 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

  • Direct secure messaging: 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.

View all 24

Hospital & facility affiliations 16

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

View all 16

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

Sources for this page

Verify at the official NPI Registry.