NPIMap

Individual provider Active NPI

Eric Hadley

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1780044552
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-01678 Issued in NC
Practice address
102 E Ravine Rd
Kingsport, TN 37660-3814
Phone
(423) 245-9600
NPI assigned
Mar 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2019-01678 NC Primary

Addresses

Primary practice location

102 E Ravine Rd
Kingsport, TN 37660-3814

Mailing address

615 Lake Forest LN Apt H3
Norton Shores, MI 49441-4733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904001631 NC Practitioner - Family Practice 7810226644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

181 Daniel Rd
Forest City, NC 28043-7151
Phone (828) 286-9036

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Shelby, NC, CCN 347317
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Rutherford Regional Medical Center Hospital, Rutherfordton, NC, CCN 340013
  • Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Sep 1, 2019 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 28, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 28, 2024 Accepting new patients
Medical Education Assistance Corporation Family Medicine PastSince Jun 15, 2008 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients
Medical Education Assistance Corporation Family Medicine Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

181 Daniel Rd
Forest City, NC 28043
Phone (828) 286-9036

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

Interoperability endpoints

  • Direct secure messaging: ehadley2938755@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1780044552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 LAKE FOREST LN APT H3",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603814",
            "telephone_number": "423-245-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-07",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.