APPALACHIAN ORTHOPAEDIC ASSOCIATES P C
Complete NPI Record 1336175462
Orthopaedic Surgery in Johnson City, TN
Active since June 23, 2006
Complete NPI Dataset
This page contains the complete raw NPPES record for Appalachian Orthopaedic Associates P C (NPI 1336175462), an orthopaedic surgery organization in Johnson City, TN. All 41 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1336175462 Field 1/41
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/41
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/41
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: APPALACHIAN ORTHOPAEDIC ASSOCIATES P C Field 4/41
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: APPALACHIAN ORTHOPAEDIC ASSOCIATES P C Field 5/41
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/41
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 3 PROFESSIONAL PARK DR Field 7/41
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: SUITE 21 Field 8/41
- The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
- Provider Business Mailing Address City Name: JOHNSON CITY Field 9/41
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TN Field 10/41
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 376046529 Field 11/41
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/41
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 4239793333 Field 13/41
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 4239266713 Field 14/41
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 3 PROFESSIONAL PARK DR Field 15/41
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Second Line Business Practice Location Address: STE 21 Field 16/41
- The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: JOHNSON CITY Field 17/41
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: TN Field 18/41
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 376046529 Field 19/41
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 20/41
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 4239793333 Field 21/41
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 4239266713 Field 22/41
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: KEENEY Field 25/41
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: DARYN Field 26/41
- The first name of the authorized official.
- Authorized Official Title or Position: DOO Field 27/41
- The title or position of the authorized official.
- Authorized Official Telephone Number: 4232391550 Field 28/41
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207X00000X Field 29/41
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 30/41
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 3710613 Field 31/41
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 32/41
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: TN Field 33/41
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 2: CD1842 Field 34/41
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 01 Field 35/41
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: TN Field 36/41
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 2: MEDICARE RAILROAD Field 37/41
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: N Field 38/41
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Name Prefix Text: MR. Field 39/41
- The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
- Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP Field 40/41
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 4
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1500 W Elk Ave, Ste 102
Location 1/4Elizabethton, TN 37643-2655 · Phone (423) 431-0405
4221 Fort Henry Dr., Ste 1
Location 2/4Kingsport, TN 37663 · Phone (423) 239-1550
260 Midway Medical Park, Ste 100
Location 3/4Bristol, TN 37620 · Phone (423) 968-4446
1 Medical Park Blvd, Ste 300E
Location 4/4Bristol, TN 37620 · Phone (423) 844-6450
Other Provider Identifiers 2
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
3710613 Medicaid
Identifier 1/2State: TN
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
CD1842 Other
Identifier 2/2State: TN · Issuer: Medicare Railroad
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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