Individual provider Active NPI

Bobby W Stiles, NP

  • Licensed Practical Nurse
  • Knoxville, TN
National Provider Identifier
1861446650
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
8240 Issued in TN
Practice address
2001 Laurel Ave
Suite N304
Knoxville, TN 37916-1810
Phone
(865) 546-9484
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 8240 TN Primary

Addresses

Primary practice location

2001 Laurel Ave
Suite N304
Knoxville, TN 37916-1810

Mailing address

2001 Laurel Ave
Suite N304
Knoxville, TN 37916-1810

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
I20050915000704 TN Practitioner - Nurse Practitioner 4587697941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Radiology, PCGroup PAC ID 9234041559, 64 clinicians

Practice addresses (Care Compare)

2001 Laurel Ave
Knoxville, TN 37916-1810
Phone (865) 546-9484

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
75.62
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8240TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Radiology, PC. CurrentSince Dec 1, 2016 Accepting new patients

Locations

Dept 888302
Knoxville, TN 37995

4709 Papermill Dr
Ste 201
Knoxville, TN 37909

6344 Lonas Spring Dr
Knoxville, TN 37909
Phone (865) 247-8422

Organizations & group practices 1

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 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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1861446650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE",
            "address_2": "SUITE N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE",
            "address_2": "SUITE N304",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-546-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "BOBBY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "8240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.