DR. VITALY GENNADIEVICH NAZAROV MD
NPI 1760469084
Internal Medicine in Kingsport, TN

Q: What is Vitaly Nazarov's NPI number?

The NPI number for Vitaly Nazarov is 1760469084. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Q: What is Vitaly Nazarov's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Vitaly Nazarov was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since December 28, 2005PECOS EnrolledAccepts Medicare Assignment

130 W RAVINE RD, KINGSPORT, TN 37660(423) 224-3628(423) 230-8502 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 21, 2025, Jul 6, 2021 (2 updates tracked since 2021).

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About Dr. Vitaly Gennadievich Nazarov Md NPPES

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

DR. VITALY GENNADIEVICH NAZAROV MD (NPI 1760469084) is an individual internal medicine provider in Kingsport, Tennessee, licensed in Missouri (2017038349) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Self Regional Healthcare, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1760469084

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. VITALY GENNADIEVICH NAZAROVCredential: MD

Location Address130 W RAVINE RDKingsport, TN 37660-3837

Mailing Address105 W Stone Dr, Suite 6aKingsport, TN 37660-3365 · (423) 408-7220 · Fax (423) 408-7405

Phone(423) 224-3628

Fax(423) 230-8502

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateDecember 28, 2005

Last NPPES UpdateNovember 21, 20252 updates tracked since enumeration

NPPES CertifiedNovember 21, 2025

✔ NPI 1760469084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MO · 2017038349

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 0101254975 (VA), 40147 (TN)

130 W RAVINE RD, Kingsport, TN 37660

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Other Names 1

Other Name (5)Vitaly Nazarov

Other Identifiers 3

Other4122077TN · Bcbst

OtherTN0119TN · John Deere Heatlhcare

Medicaid3334533TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Vitaly Gennadievich Nazarov Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830114131

PECOS Enrollment IDI20051005001193, I20171115003063

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

165 services101 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

84 services80 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

38 services25 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

29 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Self Regional Healthcare

Acute Care Hospitals · Greenwood, SC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420071

Location1325 Spring StreetGreenwood, SC 29646 · Greenwood County

Emergency services Birthing friendly

Greeneville Community Hospital

Acute Care Hospitals · Greeneville, TN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440050

Location1420 Tusculum BoulevardGreeneville, TN 37745 · Greene County

Emergency services Birthing friendly

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440063

Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

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

DME-Oxygen and Supplies · category DC000N

4 suppliers17 claims17 services$20.01 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

1 supplier12 claims12 services$768.64 avg. paid by Medicare

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

DME-Oxygen and Supplies · category DC002N

5 suppliers22 claims22 services$111.61 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

CLAIRE ELLIOTT PHARMD

Pharmacist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

WPS PROVIDERS INC

General Practice

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

JAMES ROBERT BECK PHARMACIST

Pharmacist

130 W RAVINE RD, WELLMONT OUTPATIENT PHARMACY
KINGSPORT, TN 37660

Sullivan County (423) 224-6860

MRS. REKHA S GUPTA OTR

Occupational Therapist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-5535

MRS. STACEY ANN RYDER CRNA

Nurse Anesthetist, Certified Registered

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

DR. HETVI KIRITKUMAR JOSHI M.D.

Hospitalist

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-3628

SHERRY LYNN GOODE NP

Nurse Practitioner (Family)

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-3628

PATRINA NICOLYN CRADIC FNP-C

Nurse Practitioner (Family)

130 W RAVINE RD
KINGSPORT, TN 37660

Sullivan County (423) 224-4000

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 Vitaly Nazarov's NPI number?

The NPI number for Vitaly Nazarov is 1760469084. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Where is Vitaly Nazarov located?

Vitaly Nazarov practices at 130 W Ravine Rd, Kingsport, TN 37660. The listed phone number is (423) 224-3628.

What is Vitaly Nazarov's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Vitaly Nazarov enrolled in Medicare?

Yes. Vitaly Nazarov is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Vitaly Nazarov accept?

Health plans from BlueCross BlueShield of South Carolina and Oscar Insurance Company list Vitaly Nazarov 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.

Is Vitaly Nazarov affiliated with any hospitals?

According to CMS data, Vitaly Nazarov is affiliated with Self Regional Healthcare, Greeneville Community Hospital and Johnson City Medical Center.

When was this NPI record last updated?

The NPPES record for Vitaly Nazarov was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.