Individual provider Active NPI

Reagan R Parr, M.D.

  • Orthopaedic Surgery Physician
  • Johnson City, TN
National Provider Identifier
1750351458
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
39707 Issued in TN
Practice address
3 Professional Park Dr
Suite 21
Johnson City, TN 37604-6529
Phone
(423) 434-6300
Fax
(423) 434-6312
NPI assigned
Jan 25, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 39707 TN Primary

Addresses

Primary practice location

3 Professional Park Dr
Suite 21
Johnson City, TN 37604-6529

Mailing address

3 Professional Park Dr
Suite 21
Johnson City, TN 37604-6529
Phone (423) 434-6300

Other identifiers 2

IdentifierTypeStateIssuer
5903979MedicaidNC
3329782MedicaidTN

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
I20050523000606 TN Practitioner - Orthopedic Surgery 8224070032 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39707TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Orthopaedic Associates P C Orthopaedic Surgery Current Accepting new patients
Appalachian Orthopaedic Associates P C Orthopaedic Surgery CurrentSince Jul 1, 2005 Accepting new patients
Appalachian Orthopaedic Associates P C Orthopaedic Surgery CurrentSince Jul 1, 2005 Accepting new patients

Locations

1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161

105 Meadow View Rd
Ste 4
Bristol, TN 37620
Phone (423) 844-6935

260 Midway Medical Park
Ste 100
Bristol, TN 37620
Phone (423) 968-4446

3 Professional Park Dr
Ste 10
Johnson City, TN 37604
Phone (423) 926-4331

3 Professional Park Dr
Ste 21
Johnson City, TN 37604

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1750351458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PROFESSIONAL PARK DR",
            "address_2": "SUITE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046529",
            "telephone_number": "423-434-6300",
            "fax_number": "423-434-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PROFESSIONAL PARK DR",
            "address_2": "SUITE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046529",
            "telephone_number": "423-434-6300",
            "fax_number": "423-434-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARR",
        "first_name": "REAGAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "39707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903979",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3329782",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.