Individual provider Active NPI

Mary Beth Still, APN

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1760417943
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7606 Issued in TN
Practice address
219 Princeton Road
Washington County Health Department
Johnson City, TN 37601
Phone
(423) 975-2200
Fax
(423) 975-2210
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7606 TN Primary

Addresses

Primary practice location

219 Princeton Road
Washington County Health Department
Johnson City, TN 37601

Mailing address

219 Princeton Road
Washington County Health Department
Johnson City, TN 37601
Phone (423) 975-2200

Other identifiers 1

IdentifierTypeStateIssuer
4259820OtherTNBLUECROSS BLUESHIELD OF TN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061120000337 TN Practitioner - Nurse Practitioner 0042218471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7606TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Neuroscience Center, P.C. CurrentSince Jan 12, 2014 Accepting new patients

Locations

2 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 224-3100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1760417943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 PRINCETON ROAD",
            "address_2": "WASHINGTON COUNTY HEALTH DEPARTMENT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-975-2200",
            "fax_number": "423-975-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PRINCETON ROAD",
            "address_2": "WASHINGTON COUNTY HEALTH DEPARTMENT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-975-2200",
            "fax_number": "423-975-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILL",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "7606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF TN",
            "identifier": "4259820",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.