NPIMap

Individual provider Active NPI

Reid Usedom

  • Family Medicine Physician
  • Bristol, TN
National Provider Identifier
1952832107
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-01631 Issued in NC
Practice address
208 Medical Park Blvd
Bristol, TN 37620-7343
Phone
(423) 989-4050
Fax
(423) 990-3044
NPI assigned
Mar 21, 2017
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2019-01631 NC Primary

Addresses

Primary practice location

208 Medical Park Blvd
Bristol, TN 37620-7343

Mailing address

PO Box 70621
Department of Family Medicine - Quillen College of Med
Johnson City, TN 37614
Phone (423) 439-4683

Other practice location 1

1409 Asheville Hwy
Brevard, NC 28712-9524
Phone (828) 435-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rusedom690040@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803001340 NC Practitioner - Family Practice 9234554676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henderson County Hospital CorporationGroup PAC ID 8123938115, shared by 20 NPIs, 231 clinicians

Practice addresses (Care Compare)

1409 Asheville Hwy
Brevard, NC 28712-9524
Phone (828) 435-8400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Apr 1, 2021 Accepting new patients
Henderson County Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Henderson County Hospital Corporation Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
Hendersonville Hematology and Oncology@Pardee Past Accepting new patients

Locations

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Interoperability endpoints

  • Direct secure messaging: rusedom690040@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1952832107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70621",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE - QUILLEN COLLEGE OF MED",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37614",
            "telephone_number": "423-439-4683",
            "fax_number": "423-439-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207343",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Asheville Hwy",
            "address_purpose": "LOCATION",
            "city": "Brevard",
            "state": "NC",
            "postal_code": "287129524",
            "country_code": "US",
            "telephone_number": "828-435-8400",
            "fax_number": "828-435-8401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "USEDOM",
        "first_name": "REID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rusedom690040@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1409 Asheville Hwy",
            "city": "Brevard",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287129524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.