Active NPI
Samuel O Massey III, M.D.
- Diagnostic Radiology Physician
- Johnson City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 31318
- Practice address
- 1301 Sunset Dr
Ste 3
Johnson City, TN 37604-7906 - Phone
- (423) 926-4966
- Fax
- (423) 926-1823
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 31318 | TN | Primary |
Addresses
Primary practice location
1301 Sunset Dr
Ste 3
Johnson City, TN 37604-7906
Mailing address
1301 Sunset Dr
Ste 3
Johnson City, TN 37604-7906
Phone (423) 926-4966
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3840825 | Medicaid | TN | |
| Q007699 | Medicaid | TN | |
| 1912956277 | Medicaid | VA | |
| 300104374 | Other | TN | RAILROAD MEDICARE |
| 64017064 | Other | KY | KENTUCKY MEDICAID |
| 89063JF | Other | NC | NORTH CAROLINA MEDICAID |
| 7222238 | Other | VA | VIRGINIA MEDICAID |
| 3125936 | Other | TN | BCBS |
| 100026452 | Other | TN | PHP TNCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Mississippi School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-2200
105 Fairlea CT
Lynchburg, VA 24503-2164
Phone (423) 968-1144
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 244-6800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31318 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Vista Radiology, PC. | Diagnostic Radiology | Current | Accepting new patients |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Radiology, P.C. | Diagnostic Radiology | Current | Accepting new patients |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients |
Locations
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
4289 Bonny Oaks Dr
Ste 106
Chattanooga, TN 37406
1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380
100 Greenway Cir
Erwin, TN 37650
Phone (423) 743-1271
2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867
1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000
Dept 888302
Knoxville, TN 37995
Organizations & group practices 5
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.
-
- Diagnostic Radiology Physician
- Knoxville, TN
- NPI 1386698710
-
dba Ballad Health Medical Associates
- Neurological Surgery Physician
- Johnson City, TN
- NPI 1003152307
-
dba First Assist Urgent Care
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
-
dba Ballad Health Medical Associates
- Family Medicine Physician
- Johnson City, TN
- NPI 1982553756
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Woodridge Hospital
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
dba Johnson City Medical Center
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
dba Johnson City Medical Center
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
-
dba Ballad Health Medical Associates
- General Acute Care Hospital
- Greeneville, TN
- NPI 1699819003
-
dba Bristol Regional Medical Center
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
dba Holston Valley Medical Center
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
-
- General Acute Care Hospital
- Abingdon, VA
- NPI 1104812684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1912956277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 SUNSET DR",
"address_2": "STE 3",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376047906",
"telephone_number": "423-926-4966",
"fax_number": "423-926-1823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 SUNSET DR",
"address_2": "STE 3",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376047906",
"telephone_number": "423-926-4966",
"fax_number": "423-926-1823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSEY",
"first_name": "SAMUEL",
"middle_name": "O",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "31318",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3840825",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q007699",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912956277",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300104374",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY MEDICAID",
"identifier": "64017064",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA MEDICAID",
"identifier": "89063JF",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA MEDICAID",
"identifier": "7222238",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3125936",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP TNCARE",
"identifier": "100026452",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.