NPIMap

Individual provider Active NPI

Jason Laurence Pizzola, M.D.

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1780837518
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01065937A Issued in IN
Practice address
201 Cassell Dr
Kingsport, TN 37660-3747
Phone
(423) 245-9626
NPI assigned
Oct 24, 2008
Last updated
Oct 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01065937A IN Primary

Addresses

Primary practice location

201 Cassell Dr
Kingsport, TN 37660-3747

Mailing address

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 628-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160218002117 TX Practitioner - Family Practice 7517262108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01065937AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Feb 15, 2016 Accepting new patients
Shannon Clinic Family Medicine CurrentSince Feb 15, 2016 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

Interoperability endpoints

  • Direct secure messaging: jpizzola6755@shannonhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1780837518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035919",
            "telephone_number": "325-628-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CASSELL DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603747",
            "telephone_number": "423-245-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIZZOLA",
        "first_name": "JASON",
        "middle_name": "LAURENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-24",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01065937A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.