Active NPI
Carl Eric Bendeck, MD
- Internal Medicine Physician
- Kingsport, TN
National Provider Identifier
1801828934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 27865
- Practice address
- 2000 Brookside Dr
Kingsport, TN 37660-4627 - Phone
- (423) 857-5905
- Fax
- (423) 857-5904
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27865 | TN | Primary |
Addresses
Primary practice location
2000 Brookside Dr
Kingsport, TN 37660-4627
Mailing address
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-5905
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38000321 | Medicaid | TN | |
| Q002681 | Medicaid | TN | |
| P00886934 | Other | TN | RAILROAD MEDICARE |
| 5912846 | Medicaid | NC | |
| 7100040190 | Medicaid | KY | |
| 1516316 | Medicaid | TN | |
| 1801828934 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27865 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418256000000",
"number": "1801828934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 BROOKSIDE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604627",
"telephone_number": "423-857-5905",
"fax_number": "423-857-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 BROOKSIDE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604627",
"telephone_number": "423-857-5905",
"fax_number": "423-857-5904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENDECK",
"first_name": "CARL",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2014-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "27865",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38000321",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q002681",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00886934",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5912846",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100040190",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1516316",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1801828934",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.