Individual provider Active NPI

Sherwood Barefoot, M.D.

  • Surgery Physician
  • Kingsport, TN
National Provider Identifier
1831131432
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD15114 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3810
Phone
(423) 224-4000
NPI assigned
Jun 11, 2006
Last updated
Mar 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD15114 TN Primary
Trauma Surgery Physician 2086S0127X 010140493 VA

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3810

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Other identifiers 2

IdentifierTypeStateIssuer
3868508MedicaidTN
007312202MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120914000592 NC Practitioner - General Surgery 7517919897 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13795SCMDPharmacist
MD15114TNMDSurgery Physician
010140493VAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc Surgery CurrentSince Jul 31, 2012 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Jul 31, 2012 Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Lancaster Clinic Corp Past Accepting new patients

Locations

205 Lauchwood Dr
Laurinburg, NC 28352
Phone (910) 276-4410

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1831131432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-224-3250",
            "fax_number": "423-224-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603810",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAREFOOT",
        "first_name": "SHERWOOD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD15114",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "VA",
            "license": "010140493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3868508",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007312202",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.