Mark W Emery, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

19732 Issued in TN

Practice address

111 W Stone Dr
Suite 100
Kingsport, TN 37660-6027

Phone

(423) 247-5197

Fax

(423) 247-5254

NPI assigned

May 19, 2006

Last updated

Aug 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Wellmont Medical Associates Inc

  dba Ballad Health Medical Associates

  • Pulmonary Disease Physician
  • Bristol, TN
  • NPI 1780986257
  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  dba Ballad Health Medical Associates

  • Urgent Care Clinic/Center
  • Bristol, TN
  • NPI 1770942575
  NPD
• Kingsport Bronchoscopy Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Kingsport, TN
  • NPI 1306898416
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1801849674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W STONE DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "19732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0094319",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENN CARE",
            "identifier": "100023382",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047487",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65906208",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1736855",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF THE RIVER VALLEY",
            "identifier": "Z101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY MEDICAID",
            "identifier": "64798580",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAID",
            "identifier": "006040209",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5141032",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTHCARE",
            "identifier": "62134825601",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "065196",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000908",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lea Ann Elwood-Relyea, MSW
• Eric Douglas Emberton, M.D.
• Emergent Aco, LLC
• Emeritus Corporation (Brookdale Rock Springs)
• Emeritus Corporation (Emeritus at Kingsport)
• Roxana Enache, PA-C
• Encompass Health Rehabilitation Hospital of Kingsport LLC (Encompass Health Rehabilitation Hospital of Kingsport)
• Endoscopy Center of Kingsport (Sullivan Digestive Center)
• Warren Edward English, M.D.
• Neva Gail Ennis, RN

• Pulmonary Disease Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Pulmonary Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.