NPIMap

Organization Active NPI

Wellmont Medical Associates, Inc.

  • Urgent Care Clinic/Center
  • Bristol, TN
National Provider Identifier
1770942575
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
WELLMONT MEDICAL ASSOCIATES, INC.
Practice address
1220 Volunteer Pkwy
Bristol, TN 37620-4628
Phone
(423) 274-6610
Fax
(423) 274-6619
NPI assigned
Feb 22, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cindy L Hallford
Title
Director of Professional Billing
Phone
(423) 408-7220

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20111026000909 TN Part B Supplier - Clinic/Group Practice 8123291739 Receives reassigned benefits from 960 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

NPPES NPI Registry

Primary practice location

1220 Volunteer Pkwy
Bristol, TN 37620-4628

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

Other names 1

NPPES NPI Registry
  • Ballad Health Medical Associates Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2019.

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1770942575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 VOLUNTEER PKWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204628",
            "telephone_number": "423-274-6610",
            "fax_number": "423-274-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMONT MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "HALLFORD",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF PROFESSIONAL BILLING",
        "authorized_official_telephone_number": "423-408-7220"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.