Individual provider Active NPI

John Richard Hovious III, M.D.

  • Pediatrics Physician
  • Bristol, TN
National Provider Identifier
1811994981
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0000013744 Issued in TN
Practice address
109 Meadow View Road
Suite 7
Bristol, TN 37620-1661
Phone
(423) 652-1655
Fax
(423) 652-7668
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0000013744 TN Primary

Addresses

Primary practice location

109 Meadow View Road
Suite 7
Bristol, TN 37620-1661

Mailing address

109 Meadow View Road
Suite 7
Bristol, TN 37620-1661
Phone (423) 652-1655

Other identifiers 8

IdentifierTypeStateIssuer
0000013744OtherTNMEDICAL LICENSE NUMBER
006725198MedicaidVA
096148OtherVAANTHEM
3045396MedicaidTN
44D0672628OtherTNCLIA NUMBER
71056376201OtherTNJOHN DEERE
110289OtherTNBLUECROSS/BLUESHIELD TENN
4531227OtherTNAETNA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000435 TN Practitioner - Pediatric Medicine 0143404350 Practice locations: Bristol, TN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000013744TNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1811994981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MEADOW VIEW ROAD",
            "address_2": "SUITE 7",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201661",
            "telephone_number": "423-652-1655",
            "fax_number": "423-652-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MEADOW VIEW ROAD",
            "address_2": "SUITE 7",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201661",
            "telephone_number": "423-652-1655",
            "fax_number": "423-652-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVIOUS",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "0000013744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "0000013744",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006725198",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "096148",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045396",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "44D0672628",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "71056376201",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD TENN",
            "identifier": "110289",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4531227",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.