Individual provider Active NPI

Ryan Patrick Cronin, DO

  • Vascular Surgery Physician
  • Kingsport, TN
National Provider Identifier
1942612643
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2019-02931 Issued in NC
Practice address
2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone
(423) 230-5000
NPI assigned
May 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2019-02931 NC Primary
Internal Medicine Physician 207R00000X LL36659 SC
Vascular Surgery Physician 2086S0129X 4815 TN

Addresses

Primary practice location

2050 Meadowview Pkwy
Kingsport, TN 37660-7475

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

1801 Sunset
Internal Medicine Clinic
Columbia, SC 29203
Phone (803) 434-4197

Other practice location 2

3024 Burnett-Womack Bldg Cb#7212
Chapel Hill, NC 27599-0001
Phone (919) 966-3391

Other practice location 3

378 Marketplace Blvd Ste 5
Johnson City, TN 37604-2361
Phone (423) 282-0751

Other practice location 4

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone (423) 282-5054

Other practice location 5

271 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-8600

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
I20220902002811 TN Practitioner - Vascular Surgery 9739519018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)23
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4815TNMDGeneral Practice Dentistry
LL36659SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Health System Current Accepting new patients
Wellmont Cardiology Services Vascular Surgery CurrentSince Aug 1, 2022 Accepting new patients
Wellmont Medical Associates, Inc. Internal Medicine PastSince Aug 1, 2022 Accepting new patients
Solstas Lab Partners Group LLC Past Accepting new patients
Wellmont Medical Associates Inc Past Accepting new patients

Locations

2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400

378 Marketplace Blvd
Ste 5
Johnson City, TN 37604
Phone (423) 282-0751

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2050 Meadowview Pkwy
Kingsport, TN 37660

Interoperability endpoints

  • Direct secure messaging: rcronin81259@balladhealth.medalliesdirect.net

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.

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1942612643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PKWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607475",
            "telephone_number": "423-230-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Sunset",
            "address_2": "Internal Medicine Clinic",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-4197",
            "fax_number": "803-434-4160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3024 Burnett-Womack Bldg Cb#7212",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-3391",
            "fax_number": "919-966-2898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "378 Marketplace Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042361",
            "country_code": "US",
            "telephone_number": "423-282-0751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2428 Knob Creek Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042396",
            "country_code": "US",
            "telephone_number": "423-282-5054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "271 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207455",
            "country_code": "US",
            "telephone_number": "423-274-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2019-02931",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL36659",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "4815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.