JAMES W SHINE MD
NPI 1194781724
Family Medicine in Mountain City, TN

NPI Status: Active since April 22, 2006

Contact Information

1901 S SHADY ST
MOUNTAIN CITY, TN
ZIP 37683
Phone: (423) 727-1103
Fax: (423) 727-1140

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  • Individual
  • Male
  • Family Medicine
  • PECOS Enrolled

About JAMES SHINE

This page provides the complete NPI Profile along with additional information for James Shine, a primary care provider established in Mountain City, Tennessee with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1194781724 assigned on April 2006. The practitioner's primary taxonomy code is 207Q00000X with license number MD28372 (TN). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1194781724
Provider Name
JAMES W SHINE MD
Gender
Male
Entity Type
Individual
Location Address
1901 S SHADY ST MOUNTAIN CITY, TN 37683
Location Phone
(423) 727-1103
Location Fax
(423) 727-1140
Mailing Address
1901 S SHADY ST MOUNTAIN CITY, TN 37683
Mailing Phone
(423) 727-1103
Mailing Fax
(423) 727-1140
Is Sole Proprietor?
No
Enumeration Date
04-22-2006
Last Update Date
02-23-2017
Code Navigator

A primary care provider (PCP) like James Shine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD28372
License State
TN
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

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
3803906MEDICARE PIN (08)TN 
3803906MEDICAID (05)TN 
1194781724MEDICAID (05)VA 
TN0167OTHER (01)TNJOHN DEERE
Q009917MEDICAID (05)TN 
4062642OTHER (01)TNBCBS

Medicare Participation & PECOS Enrollment Status

James Shine is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    5 DME suppliers used 18 Medicare Claims 58 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 26 Medicare Claims 26 Services Paid

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) (HCPCS:A4314)

    1 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Orthotic Devices (DF000N)

    Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

    1 DME suppliers used 22 Medicare Claims 22 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37683 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.53
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $20.38
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.6
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $23.4
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1194781724, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
8
Unchanged
Pos 7
1
Doubled → 2
Pos 8
7
Unchanged
Pos 9
2
Doubled → 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 1 → 2 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 1 + 4 + 8 + 2 + 7 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1194781724.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Women's Health)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Orthopaedic Surgery
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Emergency Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Family Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Emergency Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Internal Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Surgery
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Psychiatric/Mental Health)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Family)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Nurse Practitioner (Psychiatric/Mental Health)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
Family Medicine
1901 S SHADY ST
MOUNTAIN CITY, TN 37683
General Acute Care Hospital (Critical Access)
1901 S SHADY ST
MOUNTAIN CITY, TN 37683

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194781724, enumerated as an "individual" on April 22, 2006.

The provider is located at 1901 S SHADY ST MOUNTAIN CITY, TN 37683 and the phone number is (423) 727-1103.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.