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MITCHELL DESHAZER
NPI 1023276870
Internal Medicine - Critical Care Medicine in Johnson City, TN

Active since May 29, 2008PECOS Enrolled
400 N STATE OF FRANKLIN RD, ROOM 2746, JOHNSON CITY, TN 37604(423) 431-2727(423) 431-6715 Get Directions Write a Review

NPPES record last updated: February 1, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mitchell Deshazer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITCHELL DESHAZER (NPI 1023276870) is an individual critical care medicine provider in Johnson City, Tennessee, licensed in Tennessee (51285) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023276870
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameMITCHELL DESHAZER
Location Address400 N STATE OF FRANKLIN RD, ROOM 2746Johnson City, TN 37604-6035
Mailing Address400 N State Of Franklin Rd, Room 2746Johnson City, TN 37604-6035 · (423) 431-2727 · Fax (423) 431-6715
Phone(423) 431-2727
Fax(423) 431-6715
Sole ProprietorYes
Enumeration DateMay 29, 2008
Last NPPES UpdateFebruary 1, 2017
✔ NPI 1023276870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in TN · 51285
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License 51285 (TN), 7932447-1205 (UT), N2058 (TX)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 51285 (TN)
Also ListedHospitalistTaxonomy 208M00000X · License N2058 (TX)
400 N STATE OF FRANKLIN RD, Johnson City, TN 37604
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Other Identifiers 6

OtherP01365055TN · Railroad Medicare
Medicaid1023276870VA
MedicaidQ007623TN
Medicaid7100376940KY
Medicare PIN103I112082TN
Medicaid1023276870NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mitchell Deshazer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mitchell Deshazer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Ridge Medical Management Corporation
Same address
Cardiovascular Disease
400 N STATE OF FRANKLIN RD, ROOM LK015
Johnson City, TN 37604
  • Reassigned Medicare billing, Tennessee enrollment
  • 496 clinicians in this Medicare group
NPI 1003273251 (423) 431-5965

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CASEY JAMES WILBERT PHARM.D
Pharmacist
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-2787
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Internal Medicine (Cardiovascular Disease)
400 N STATE OF FRANKLIN RD, ROOM LK015
JOHNSON CITY, TN 37604
Washington County (423) 431-5965
DR. ANDREW LEE GIBSON MD
Emergency Medicine
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-6111
MCKENZIE PEARL GREGG PA-C, MMS, MPH
Physician Assistant
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-6111
OLUWATOSIN ORIOLA AYANJOKE MD
Family Medicine
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-6111
HUNTER DORTON
Student in an Organized Health Care Education/Training Program
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-6111
DR. LEON CHARLES BASS M.D.
Internal Medicine (Pulmonary Disease)
400 N STATE OF FRANKLIN RD, ROOM 2746
JOHNSON CITY, TN 37604
Washington County (423) 431-2727
DR. THOMAS M SOIKE M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604
Washington County (423) 431-1310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mitchell Deshazer's NPI number?

The NPI number for Mitchell Deshazer is 1023276870. It was assigned to this individual provider in the NPPES registry on May 29, 2008.

Where is Mitchell Deshazer located?

Mitchell Deshazer practices at 400 N State Of Franklin Rd Room 2746, Johnson City, TN 37604. The listed phone number is (423) 431-2727.

What is Mitchell Deshazer's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Mitchell Deshazer enrolled in Medicare?

Yes. Mitchell Deshazer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mitchell Deshazer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mitchell Deshazer reassigns Medicare benefits to Blue Ridge Medical Management Corporation (Johnson City, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mitchell Deshazer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mitchell Deshazer accept?

Health plans from Cigna Healthcare list Mitchell Deshazer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mitchell Deshazer was last updated on February 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.