Jose Garrido, M.D.
Individual provider Active NPI Internal Medicine Physician · Bulls Gap, TN
NPI 1982640140 · NPPES record last updated Sep 20, 2023
Key facts
- NPI
- 1982640140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD0039603 (TN)
- Practice address
- 273 Highway 11 E
Bulls Gap, TN 37711-3433 - Phone
- (423) 393-4146
- Fax
- (423) 393-4377
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050812000732 | TN | Practitioner - Internal Medicine | 7416987144 | Reassigns benefits to 2 organizations |
| I20120404000003 | VA | Practitioner - Internal Medicine | 7416987144 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0039603 | TN | MD | Internal Medicine Physician |
| 39603 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emmaus Medical and Counseling, PLLC | Addiction Medicine | Current |
Accepting new patients |
| Southeastern Physician Services PC | Internal Medicine | Current |
Accepting new patients |
| Abingdon Internal Medicine PC | Internal Medicine | Current |
Accepting new patients |
| Southwestern Virginia Mental Health Institute | Current |
Accepting new patients | |
| Southwestern Virginia Mental Health Institute | Hospitalist | Current |
Accepting new patients |
| Holy Cross Hospital Inc | Internal Medicine | Past | Accepting new patients |
| Vega Health Center Inc | Internal Medicine | Past |
Accepting new patients |
| Bristol Consultants PC | Internal Medicine | Past |
Accepting new patients |
| Scott County Drug | Past |
Accepting new patients | |
| Mobile Occ Med and Wellness, PLLC | Past |
Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
1 Medical Park Blvd
Ste 350W
Bristol, TN 37620
Phone (423) 844-4240
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
273 Highway 11 E
Bulls Gap, TN 37711
Phone (423) 393-4146
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
322 Valley St NE
Abingdon, VA 24210
Phone (276) 628-1106
15051 Harmony Hills Ln
Abingdon, VA 24211
Phone (276) 451-2590
103 North St
Bristol, VA 24201
Phone (276) 642-7901
2966 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-8144
340 Bagley Cir
Marion, VA 24354
Phone (276) 783-1200
2834 US Highway 23 North
Weber City, VA 24290
Phone (276) 386-3161
600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JFJCCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 39603 | TN | |
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 39603 | TN | |
| Hospitalist Physician | 208M00000X | 39603 | TN | |
| Internal Medicine Physician | 207R00000X | MD0039603 | TN | Yes |
Addresses
Primary practice location
273 Highway 11 E
Bulls Gap, TN 37711-3433
Mailing address
273 Highway 11 E
Bulls Gap, TN 37711-3433
Phone (423) 393-4146
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3332506 | Medicaid | TN | |
| 3332507 | Medicaid | TN | |
| 010186285 | Medicaid | VA |
Other providers in Bulls Gap, TN
- Cunningham Drugs
- Mark R Doman
- Leslie Renee Elliott
- Emmaus Medical and Counseling, PLLC
- Gregory Flora
- Kristie Vaughn Greenlee
- Megan Ann Hensley
- Linda S Housewright
- Timothy D Humann
- Lark Medical Associates, LLC
All providers in Bulls Gap, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.