Individual provider Active NPI

Wayne David Durbin, PA-C

  • Medical Physician Assistant
  • Kingsport, TN
National Provider Identifier
1801981345
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
834 Issued in TN
Practice address
4600 Fort Henry Dr
Kingsport, TN 37663-2617
Phone
(423) 224-3950
NPI assigned
Oct 3, 2006
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 834 TN Primary

Addresses

Primary practice location

4600 Fort Henry Dr
Kingsport, TN 37663-2617

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

396 N Spring St
Sparta, TN 38583-1327
Phone (931) 836-2228

Other practice location 2

2686 W State St
Bristol, TN 37620-1817
Phone (423) 844-0026

Other practice location 3

438 E Vann Rd Ste 301
Greeneville, TN 37743-7202
Phone (423) 636-9828

Other practice location 4

111 W Stone Dr Ste 110
Kingsport, TN 37660-6027
Phone (423) 224-3701

Other practice location 5

405 Scenic Dr Ste A
Rogersville, TN 37857-2441
Phone (423) 921-3490

Other practice location 6

1497 W Elk Ave Ste 11
Elizabethton, TN 37643-2896
Phone (423) 542-8929

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070328000124 TN Practitioner - Physician Assistant 0345265989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

405 Scenic Dr
Rogersville, TN 37857-2441
Phone (423) 272-2111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
834TNMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Crossroads Urgent Care PLLC CurrentSince Mar 3, 2019 Accepting new patients
Crossroads Urgent Care PLLC CurrentSince Mar 3, 2019 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Wellmont Health System Current Accepting new patients

Locations

1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161

2686 W State St
Bristol, TN 37620
Phone (423) 844-0026

438 E Vann Rd
Ste 301
Greeneville, TN 37743
Phone (423) 278-1650

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

111 W Stone Dr
Ste 110
Kingsport, TN 37660
Phone (423) 224-3701

2636 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 200-3225

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014

405 Scenic Dr
Ste A
Rogersville, TN 37857
Phone (423) 272-2111

Interoperability endpoints

  • Direct secure messaging: wdurbin317842@balladhealth.medalliesdirect.net

Organizations & group practices 6

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 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1801981345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632617",
            "telephone_number": "423-224-3950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "396 N Spring St",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "TN",
            "postal_code": "385831327",
            "country_code": "US",
            "telephone_number": "931-836-2228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2686 W State St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376201817",
            "country_code": "US",
            "telephone_number": "423-844-0026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "438 E Vann Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377437202",
            "country_code": "US",
            "telephone_number": "423-636-9828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 W Stone Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606027",
            "country_code": "US",
            "telephone_number": "423-224-3701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Scenic Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "TN",
            "postal_code": "378572441",
            "country_code": "US",
            "telephone_number": "423-921-3490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1497 W Elk Ave Ste 11",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432896",
            "country_code": "US",
            "telephone_number": "423-542-8929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "WAYNE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.