NPIMap

Individual provider Active NPI

Heesuk Richard Yoon, M.D.

  • Vascular Surgery Physician
  • Johnson City, TN
National Provider Identifier
1841499191
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
49586 Issued in TN
Practice address
2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone
(423) 282-5054
Fax
(423) 283-0516
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD444891 PA
Vascular Surgery Physician 2086S0129X 49586 TN Primary

Addresses

Primary practice location

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396

Mailing address

2 Professional Park Dr
Suite 11
Johnson City, TN 37604-6583
Phone (423) 434-0642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130624000341 TN Practitioner - General Surgery 1759520729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Texas a & M University System, HSC, College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD444891PAMDVascular Surgery Physician
49586TNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc CurrentSince Sep 1, 2019 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Wellmont Cardiology Services Vascular Surgery CurrentSince Feb 1, 2017 Accepting new patients

Locations

2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400

2050 Meadowview Pkwy
Kingsport, TN 37660

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1841499191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PROFESSIONAL PARK DR",
            "address_2": "SUITE 11",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046583",
            "telephone_number": "423-434-0642",
            "fax_number": "423-434-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 KNOB CREEK RD STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042396",
            "telephone_number": "423-282-5054",
            "fax_number": "423-283-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "HEESUK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD444891",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "49586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.