NPIMap

Individual provider Active NPI

David A Sibley, M.D,

  • Anatomic Pathology & Clinical Pathology Physician
  • Johnson City, TN
National Provider Identifier
1871568121
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD0000019825 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone
(423) 431-6913
Fax
(423) 928-8099
NPI assigned
Feb 21, 2006
Last updated
Feb 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD0000019825 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

PO Box 52990
Greenwood, SC 29649-0048
Phone (864) 223-3600

Other identifiers 3

IdentifierTypeStateIssuer
3047660MedicaidTN
64927213MedicaidKY
6650473MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101005000457 TN Practitioner - Pathology 4183710031 Reassigns benefits to 1 organization
I20221129000668 VA Practitioner - Pathology 4183710031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Virginia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Pathology Associates PCGroup PAC ID 4183718380, 12 clinicians

Practice addresses (Care Compare)

16000 Johnson Memorial Dr
Abingdon, VA 24211-7664
Phone (276) 258-1000

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-1310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.82 of 100Reported as group
Quality
76.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000019825TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Pathology Associates PC Current Accepting new patients
Watauga Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Aug 14, 1989 Accepting new patients
Laboratory Corporation of America Holdings Past Accepting new patients
Laboratory Corporation of America Holdings Past Accepting new patients

Locations

2700 S Roan St
Ste 105
Johnson City, TN 37601
Phone (423) 283-0430

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

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.

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1871568121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52990",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490048",
            "telephone_number": "864-223-3600",
            "fax_number": "864-223-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-6913",
            "fax_number": "423-928-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBLEY",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "MD0000019825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047660",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64927213",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6650473",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.