Individual provider Active NPI

Paul Charles Villeneuve, MD

  • Psychiatry Physician
  • Kingsport, TN
National Provider Identifier
1962432633
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD0000035279 Issued in TN
Practice address
2001 Stonebrook PL
Kingsport, TN 37660-4000
Phone
(423) 224-1000
Fax
(423) 224-1023
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD0000035279 TN Primary

Addresses

Primary practice location

2001 Stonebrook PL
Kingsport, TN 37660-4000

Mailing address

2001 Stonebrook PL
Kingsport, TN 37660-4000
Phone (423) 224-1000

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
I20040806000026 TN Practitioner - Psychiatry 4587636071 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000035279TNMDPsychiatry Physician
35279TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Health CurrentSince Apr 13, 2010 Accepting new patients

Locations

607 Baxter St
Johnson City, TN 37601
Phone (423) 232-2670

1167 Spratlin Park Dr
Johnson City, TN 37615
Phone (423) 232-2670

2001 E Stonebrook Pl
Kingsport, TN 37660
Phone (423) 224-1000

318 Donnelly St
Mountain City, TN 37683
Phone (423) 727-2100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1962432633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 STONEBROOK PL",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604000",
            "telephone_number": "423-224-1000",
            "fax_number": "423-224-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 STONEBROOK PL",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604000",
            "telephone_number": "423-224-1000",
            "fax_number": "423-224-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLENEUVE",
        "first_name": "PAUL",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000035279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.