Individual provider Active NPI

Thomas Rogers, MD

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1891798575
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 17577 Issued in TN
Practice address
1325 E Center St
Kingsport, TN 37664-2444
Phone
(423) 245-2078
Fax
(423) 245-2078
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD 17577 TN Primary

Addresses

Primary practice location

1325 E Center St
Kingsport, TN 37664-2444

Mailing address

1325 E Center St
Kingsport, TN 37664-2444
Phone (423) 245-2078

Other identifiers 2

IdentifierTypeStateIssuer
5637180MedicaidVA
3026843MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040811001077 TN Practitioner - Family Practice 8921070715 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 17577TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health & Wellness PLLC CurrentSince Aug 2, 2017 Accepting new patients
Apple Healthcare Group CurrentSince Jun 22, 2015 Accepting new patients
Apple Healthcare Group, PC CurrentSince Jun 22, 2015 Accepting new patients
Legacy Vein Center PLLC PastSince May 15, 2016 Accepting new patients

Locations

801 E Watauga Ave
Ste 2
Johnson City, TN 37601
Phone (423) 773-0300

4307 Ball Camp Pike
Knoxville, TN 37921
Phone (865) 524-1234

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1891798575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E CENTER ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642444",
            "telephone_number": "423-245-2078",
            "fax_number": "423-245-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E CENTER ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642444",
            "telephone_number": "423-245-2078",
            "fax_number": "423-245-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD 17577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5637180",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3026843",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.