NPIMap

Organization Active NPI

Surgical Group of Johnson City, MPC

  • Surgery Physician
  • Johnson City, TN
National Provider Identifier
1750301685
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD19488 Issued in TN
Legal business name
SURGICAL GROUP OF JOHNSON CITY, MPC
Practice address
310 N State of Franklin Rd Ste 404
Johnson City, TN 37604-6063
Phone
(423) 975-0764
Fax
(423) 975-0141
NPI assigned
Jul 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott D Watson, MDNPI 1497732929
Title
President
Phone
(423) 975-0764

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD19488 TN Primary

Addresses

Primary practice location

310 N State of Franklin Rd Ste 404
Johnson City, TN 37604-6063

Mailing address

310 N State of Franklin Rd Ste 404
Johnson City, TN 37604-6063
Phone (423) 975-0764

National Provider Directory

National Provider Directory

Locations

2333 Knob Creek Rd
Ste 16
Johnson City, TN 37604
Phone (423) 975-0764

310 N State of Franklin Rd
Ste 404
Johnson City, TN 37604
Phone (423) 975-0764

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750301685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 404",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-975-0764",
            "fax_number": "423-975-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 404",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-975-0764",
            "fax_number": "423-975-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP OF JOHNSON CITY, MPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-975-0764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD19488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.