Active NPI
Robert Winston Pannell, DC
- Rehabilitation Chiropractor
- Kingsport, TN
National Provider Identifier
1952472359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- DC0000000340
- Practice address
- 613 A Watauga Street
Dr Robert W Pannell
Kingsport, TN 37660 - Phone
- (423) 246-1963
- Fax
- (423) 246-6452
- NPI assigned
- Nov 10, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | DC0000000340 | TN | Primary |
Addresses
Primary practice location
613 A Watauga Street
Dr Robert W Pannell
Kingsport, TN 37660
Mailing address
613 A Watauga Street
Attention Dr Robert W Pannell
Kingsport, TN 37660
Phone (423) 246-1963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0020645 | Other | TN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0000000340 | TN | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952472359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 A WATAUGA STREET",
"address_2": "ATTENTION DR ROBERT W PANNELL",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37660",
"telephone_number": "423-246-1963",
"fax_number": "423-246-6452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 A WATAUGA STREET",
"address_2": "DR ROBERT W PANNELL",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37660",
"telephone_number": "423-246-1963",
"fax_number": "423-246-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNELL",
"first_name": "ROBERT",
"middle_name": "WINSTON",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "TN",
"license": "DC0000000340",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0020645",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.