Individual provider Active NPI

Abigail Lee Stiles, PA

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1891314639
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4110 Issued in TN
Practice address
2410 Susannah St
Johnson City, TN 37601-1748
Phone
(423) 282-9011
NPI assigned
Apr 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4110 TN Primary

Addresses

Primary practice location

2410 Susannah St
Johnson City, TN 37601-1748

Mailing address

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

Other practice location 1

875 Larry Neil Way
Kingsport, TN 37660-6368
Phone (423) 282-9011

Other practice location 2

340 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 282-9011

Other practice location 3

2412 Susannah St
Johnson City, TN 37601-1726
Phone (423) 282-9011

Other practice location 4

1132 Erwin Hwy
Greeneville, TN 37745-4405
Phone (423) 282-9011

Other names 1

  • Abigail Lee Dittig Former name

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
I20200624002933 TN Practitioner - Physician Assistant 5597187823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Orthopaedics PLCGroup PAC ID 1456246479, 85 clinicians

Practice addresses (Care Compare)

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

340 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 282-9011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4110TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Orthopaedics, PLC Physician Assistant CurrentSince Sep 1, 2022 Accepting new patients
Watauga Orthopaedics PLC Physician Assistant CurrentSince Sep 1, 2022 Accepting new patients

Locations

340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011

2412 Susannah St
Johnson City, TN 37601
Phone (423) 282-8070

2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011

875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011

Interoperability endpoints

  • Direct secure messaging: abigail.dittig.1@3374.direct.athenahealth.com

Organizations & group practices 2

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 4

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": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1891314639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Larry Neil Way",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606368",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Steeles Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376209532",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2412 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011726",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1132 Erwin Hwy",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454405",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILES",
        "first_name": "ABIGAIL",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-12",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "DITTIG",
            "middle_name": "LEE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.