Individual provider Active NPI

George Oliver Halstead, M.D.

  • General Practice Physician
  • Abingdon, VA
National Provider Identifier
1942593603
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101249165 Issued in VA
Practice address
137 Court St SE
Abingdon, VA 24210-3305
Phone
(276) 477-1400
Fax
(276) 477-1401
NPI assigned
May 26, 2011
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101249165 VA Primary

Addresses

Primary practice location

137 Court St SE
Abingdon, VA 24210-3305

Mailing address

2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone (423) 434-6677

Other identifiers 2

IdentifierTypeStateIssuer
1942593603MedicaidVA
Q105284MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20190722001318 VA Practitioner - General PracticePractitioner - Addiction Medicine 1254558877 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Recovery, PLLC Addiction Medicine CurrentSince Feb 25, 2026 Accepting new patients
Renaissance Medical Care Addiction Medicine Past Accepting new patients
Applegate Health Services, Inc PastSince Jun 15, 2021 Accepting new patients

Locations

2408 Susannah St
Ste 1
Johnson City, TN 37601
Phone (423) 282-5054

137 Court St SE
Abingdon, VA 24210
Phone (276) 477-1400

1662 Bonham Rd
Bristol, VA 24201
Phone (276) 644-9899

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1942593603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011765",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 COURT ST SE",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103305",
            "telephone_number": "276-477-1400",
            "fax_number": "276-477-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "GEORGE",
        "middle_name": "OLIVER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101249165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942593603",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q105284",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.