NPIMap

Individual provider Active NPI

Michael R Mabry, DO

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1982130993
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3569 Issued in TN
Practice address
303 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2392
Phone
(423) 282-5611
Fax
(423) 282-5712
NPI assigned
May 11, 2017
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3569 TN Primary

Addresses

Primary practice location

303 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2392

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 282-5611

Other practice location 1

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 439-4683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190405000794 TN Practitioner - Family Practice 7416298187 Reassigns benefits to 1 organization

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
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

303 Med Tech Pkwy
Johnson City, TN 37604-2391
Phone (423) 282-8070

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Nov 15, 2020 Accepting new patients
Medical Specialists of Johnson City PastSince Aug 1, 2020 Accepting new patients

Locations

215 E Springbrook Dr
Johnson City, TN 37601
Phone (423) 530-7900

303 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 282-5611

303 Med Tech Pkwy
Ste 100
Johnson City, TN 37604
Phone (423) 282-5611

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michaelmabry@sofha.allscriptsdirect.net

Organizations & group practices 3

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1982130993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042392",
            "telephone_number": "423-282-5611",
            "fax_number": "423-282-5712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-439-4683",
            "fax_number": "423-439-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MABRY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "3569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.