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MR. CRAIG D SCHMALZRIED M.D.
NPI 1831167741
Family Medicine in Elizabethton, TN

Active since March 08, 2006PECOS EnrolledAccepts Medicare Assignment
1505 W ELK AVE STE 2, ELIZABETHTON, TN 37643(423) 547-3380 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Craig D Schmalzried M.d. NPPES

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

MR. CRAIG D SCHMALZRIED M.D. (NPI 1831167741) is an individual family medicine provider in Elizabethton, Tennessee, licensed in Tennessee (MD0000037421) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Sycamore Shoals Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1831167741
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. CRAIG D SCHMALZRIEDCredential: M.D.
Location Address1505 W ELK AVE STE 2Elizabethton, TN 37643-2848
Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 302-6565
Phone(423) 547-3380
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 1998
Enumeration DateMarch 8, 2006
Last NPPES UpdateAugust 27, 2024
NPPES CertifiedAugust 27, 2024
✔ NPI 1831167741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TN · MD0000037421
Definition
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License MD0000037421 (TN)
1505 W ELK AVE STE 2, Elizabethton, TN 37643
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11404 Tusculum Blvd, suite 2100/2300Greeneville, TN 37745-4395 · Phone (423) 638-1188 · Fax (423) 636-1514
Location 21497 W Elk Ave Ste 21Elizabethton, TN 37643-2896 · Phone (423) 543-1261

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.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

Mr. Craig D Schmalzried M.d. 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 ID7214063825
PECOS Enrollment IDI20100407000020
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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
242 services63 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
78 services49 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
49 services49 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
44 services44 patients

Hospital Affiliations CMS Care Compare 2

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

Sycamore Shoals Hospital

Acute Care Hospitals · Elizabethton, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440018
Location1501 West Elk AvenueElizabethton, TN 37643 · Carter County
Emergency services

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 37643 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
3 suppliers15 claims36 services$6.70 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$16.15 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
2 suppliers24 claims24 services$84.41 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 3

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

MICHAEL SEAN LUEDEMAN MD
Family Medicine
1505 W ELK AVE STE 2
ELIZABETHTON, TN 37643
Carter County (423) 543-1261
MRS. PRABHA JAISHWAL LONG FNP
Nurse Practitioner (Family)
1505 W ELK AVE STE 2
ELIZABETHTON, TN 37643
Carter County (423) 543-1261
DR. SABAINA ARSHAD M.D.
Family Medicine
1505 W ELK AVE STE 2
ELIZABETHTON, TN 37643
Carter County (423) 543-1261

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 Craig Schmalzried's NPI number?

The NPI number for Craig Schmalzried is 1831167741. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Where is Craig Schmalzried located?

Craig Schmalzried practices at 1505 W Elk Ave Ste 2, Elizabethton, TN 37643. The listed phone number is (423) 547-3380.

What is Craig Schmalzried's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Craig Schmalzried enrolled in Medicare?

Yes. Craig Schmalzried 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 Craig Schmalzried accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Craig Schmalzried 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 Craig Schmalzried affiliated with any hospitals?

According to CMS data, Craig Schmalzried is affiliated with Sycamore Shoals Hospital and Johnson City Medical Center.

When was this NPI record last updated?

The NPPES record for Craig Schmalzried was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.