Michael Bryanne Villalba

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

29178 Issued in TN

Practice address

310 N State of Franklin Rd Ste 202
Johnson City, TN 37604-6063

Phone

(423) 929-7111

Fax

(423) 929-9448

NPI assigned

Jul 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Lincoln Memorial University Medical Department, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gastrointestinal Associates of Northeast Tennessee, PCGroup PAC ID 7416923396, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

Merit-based Incentive Payment System (MIPS)

Final score

93.67 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

78.91

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gastrointestinal Associates of Northeast Tennessee, PC

  • Gastroenterology Physician
  • Johnson City, TN
  • NPI 1578529632

  Single Specialty

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1114033628
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1972121127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 202",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-929-7111",
            "fax_number": "423-929-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 202",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-929-7111",
            "fax_number": "423-929-9448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Coolidge St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377434672",
            "country_code": "US",
            "telephone_number": "423-929-7111",
            "fax_number": "423-929-9448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Coolidge St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377434672",
            "country_code": "US",
            "telephone_number": "423-929-7111",
            "fax_number": "423-929-9448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "MICHAEL",
        "middle_name": "BRYANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "215795",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "29178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shenoah Jade Vicars, OTR/L
• Tara Vick, MD
• Victory Orthotics & Prosthetics LLC
• Victory Vision, PLLC
• Meaghan Marie Viggiani, MA
• Jose Villanueva, PT
• Juan Carlos Simon Villegas Gomez, ATC
• Elizabeth A Villier, CRNA
• Alexa Marie Vincent, NP
• Rachael Marie Vines, BS

• Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.