EAST TENNESSEE BRAIN & SPINE CENTER, PC
NPI 1366452914
Neurological Surgery in Johnson City, TN
NPI Status: Active since August 08, 2006
Contact Information
701 MED TECH PKWY
SUITE 300
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 232-8301
Fax: (423) 232-8304
- Organization
- Neurological Surgery
- Accepts Insurance
About EAST TENNESSEE BRAIN & SPINE CENTER, PC
This page provides the complete NPI Profile along with additional information for East Tennessee Brain & Spine Center, Pc, a provider established in Johnson City, Tennessee operating as a Neurological Surgery. The healthcare provider is registered in the NPI registry with number 1366452914 assigned on August 2006. The practitioner's primary taxonomy code is 207T00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. East Tennessee Brain & Spine Center, Pc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. David A. Wiles Md (President)
- NPI
- 1366452914
- Provider Name
- EAST TENNESSEE BRAIN & SPINE CENTER, PC
- Entity Type
- Organization
- Location Address
- 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604
- Location Phone
- (423) 232-8301
- Location Fax
- (423) 232-8304
- Mailing Address
- PO BOX 9150 PADUCAH, KY 42002
- Mailing Phone
- (270) 744-9600
- Mailing Fax
- (423) 232-8304
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-08-2006
- Last Update Date
- 06-06-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Neurological Surgery
- Taxonomy Code
- 207T00000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- TN
- Taxonomy Description
- A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | (TN) |
| 2 | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 3 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect Bronze 3500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Bronze 7500 Indiv Med Deductible - EPO
- Connect Bronze 8500 Indiv Med Deductible - EPO
- Connect Bronze CMS Standard - EPO
- Connect Gold CMS Standard - EPO
- Connect Silver 2500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Silver 2875 Indiv Med Deductible - EPO
- Connect Silver 3825 Indiv Med Deductible - EPO
- Connect Silver CMS Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7100132610 | MEDICAID (05) | KY | |
| 3721061 | MEDICAID (05) | TN | |
| 3721061 | MEDICARE PIN (08) | TN | |
| 1366452914 | MEDICAID (05) | VA | |
| 4069221 | OTHER (01) | TN | BLUE CROSS/BLUE SHIELD |
| 5903904 | MEDICAID (05) | NC | |
| CH8343 | MEDICARE PIN (08) | TN | |
| 6193510001 | MEDICARE NSC (07) | TN |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 6 | 6 | 4 | 5 | 2 | 9 | 1 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 12 | 6 | 8 | 5 | 4 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 2 + 6 + 8 + 5 + 4 + 9 + 2 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1366452914 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 18 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1659360071 | EAST TENNESSEE AMBULATORY SURGERY CENTER LLC Organization | Clinic/Center (Ambulatory Surgical) | 701 MED TECH PKWY JOHNSON CITY, TN 37604 (423) 283-7302 |
| 1821035908 | MR. ISAAC NATHAN O'DELL PA Individual | Physician Assistant (Surgical) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1124065990 | MR. WESLEY EUGENE PERRY PA Individual | Physician Assistant (Surgical) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1679592174 | KATHERINE R. BURNISTON FNP Individual | Nurse Practitioner (Family) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (432) 232-8301 |
| 1629088364 | DR. TIMOTHY MICHAEL FULLAGAR M.D. Individual | Neurological Surgery | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1487978631 | THERESA MARIE HUFF P.T. Individual | Physical Therapist | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1780957738 | RICHARD CHRISTOPHER MAUPIN PA-C Individual | Physician Assistant (Surgical) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1013257526 | ALLIANCE ANESTHESIA PLLC Organization | Nurse Anesthetist, Certified Registered | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (615) 620-2320 |
| 1215276654 | BAILEY ELIZABETH QUALLS PA-C Individual | Physician Assistant | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1083046791 | AMBER PRESTON BUTLER FNP Individual | Nurse Practitioner (Family) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1134427149 | CATHERINE MOYER DPT Individual | Physical Therapist | 701 MED TECH PKWY SUITE 301 JOHNSON CITY, TN 37604 (423) 232-8302 |
| 1275959306 | HOLLY WHITT Individual | Physical Therapist | 701 MED TECH PKWY SUITE 301 JOHNSON CITY, TN 37604 (615) 373-1350 |
| 1750518544 | DR. SELMA KOMINEK MD Individual | Neurological Surgery | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1528482924 | ERIN DOUGLAS PA Individual | Physician Assistant (Medical) | 701 MED TECH PKWY SUITE 300 JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1306885736 | EAST TENNESSEE ANESTHESIA SERVICES, PLLC Organization | Anesthesiology | 701 MED TECH PKWY JOHNSON CITY, TN 37604 (423) 283-7302 |
| 1902319585 | JOSH PARTIN PA-C Individual | Physician Assistant | 701 MED TECH PKWY JOHNSON CITY, TN 37604 (423) 232-8301 |
| 1497705743 | AARON CHRISTOPHER BROWN MD Individual | Anesthesiology | 701 MED TECH PKWY JOHNSON CITY, TN 37604 (423) 283-7302 |
| 1285117606 | SHANE STEPHENS Individual | Nurse Practitioner (Psychiatric/Mental Health) | 701 MED TECH PKWY JOHNSON CITY, TN 37604 (423) 302-3480 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366452914, enumerated in the NPI registry as an "organization" on August 08, 2006
The provider is located at 701 Med Tech Pkwy Suite 300 Johnson City, Tn 37604 and the phone number is (423) 232-8301
This medical organization specializes in Neurological Surgery with taxonomy code 207T00000X
The provider might be accepting Accepts: Cigna Healthcare, Medicare, Medicaid and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on August 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.