EAST TENNESSEE BRAIN & SPINE CENTER, PC
NPI 1366452914
Neurological Surgery in Johnson City, TN

Active since August 08, 2006CLIA 44D1102346 · Waiver
701 MED TECH PKWY, SUITE 300, JOHNSON CITY, TN 37604(423) 232-8301(423) 232-8304 Get Directions Write a Review

NPPES record last updated: June 6, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About East Tennessee Brain & Spine Center, Pc NPPES

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

EAST TENNESSEE BRAIN & SPINE CENTER, PC (NPI 1366452914) is a healthcare organization registered as a neurological surgery in Johnson City, Tennessee and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists David A. Wiles, President, as its authorized official.

NPPES Registry Identity

NPI1366452914
Entity TypeOrganization
Primary Taxonomy207T00000X
Legal Business NameEAST TENNESSEE BRAIN & SPINE CENTER, PC
Location Address701 MED TECH PKWY, SUITE 300Johnson City, TN 37604-2365
Mailing AddressPo Box 9150Paducah, KY 42002-9150 · (270) 744-9600 · Fax (270) 744-0834
Fax(423) 232-8304
Organization SubpartNo
Authorized OfficialDavid A. WilesPresident · (423) 232-8301
Enumeration DateAugust 8, 2006
Last NPPES UpdateJune 6, 2012
NPI 1366452914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyNeurological SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207T00000X
Definition
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.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
701 MED TECH PKWY, Johnson City, TN 37604

Other Identifiers 8

Medicaid7100132610KY
Medicaid3721061TN
Medicare PIN3721061TN
Medicaid1366452914VA
Other4069221TN · Blue Cross/blue Shield
Medicaid5903904NC
Medicare PINCH8343TN
Medicare NSC6193510001TN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D1102346

East Tennessee Brain And Spine Dba Ballad Health Medical Associates · Johnson City, TN
Active · expires Jul 15, 2027
CLIA Number44D1102346
Laboratory TypePhysician Office
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorDr. Wayne M. Woodbury
Laboratory Phone(423) 232-8301
Laboratory LocationEast Tennessee Brain And Spine Dba Ballad Health Medical Associates701 Med Tech Parkway Suite 300, Johnson City, TN 37604
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 19

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

Nurse Anesthetist, Certified Registered
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Nurse Practitioner (Family)
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Physician Assistant (Surgical)
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Physical Therapist
701 MED TECH PKWY, SUITE 301
JOHNSON CITY, TN 37604
Physician Assistant
701 MED TECH PKWY, SUITE 300
JOHNSON CITY, TN 37604
Physical Therapist
701 MED TECH PKWY, SUITE 301
JOHNSON CITY, TN 37604
Nurse Practitioner (Psychiatric/Mental Health)
701 MED TECH PKWY
JOHNSON CITY, TN 37604
Anesthesiology
701 MED TECH PKWY
JOHNSON CITY, TN 37604

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 East Tennessee Brain & Spine Center, PC's NPI number?

The NPI number for East Tennessee Brain & Spine Center, PC is 1366452914. It was assigned to this organization in the NPPES registry on August 8, 2006.

Where is East Tennessee Brain & Spine Center, PC located?

East Tennessee Brain & Spine Center, PC is located at 701 Med Tech Pkwy Suite 300, Johnson City, TN 37604. The listed phone number is (423) 232-8301.

What is East Tennessee Brain & Spine Center, PC's specialty?

The primary specialty registered for this NPI is Neurological Surgery with taxonomy code 207T00000X.

Does East Tennessee Brain & Spine Center, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D1102346) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Tennessee Brain & Spine Center, PC was last updated on June 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.