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DR. JAMES W DENHAM M.D.
NPI 1902088644
Pathology - Anatomic Pathology & Clinical Pathology in Kingsport, TN

Active since December 05, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2204 PAVILION DR, KINGSPORT, TN 37660(423) 392-6343 Get Directions Write a Review

NPPES record last updated: March 8, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. James W Denham M.d. NPPES

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

DR. JAMES W DENHAM M.D. (NPI 1902088644) is an individual anatomic pathology & clinical pathology provider in Kingsport, Tennessee, licensed in Tennessee (MD0000039760) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS and is a graduate of Louisiana State University School Of Medicine In New Orleans (2002).

NPPES Registry Identity

NPI1902088644
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameDR. JAMES W DENHAMCredential: M.D.
Location Address2204 PAVILION DRKingsport, TN 37660-4657
Mailing Address2204 Pavilion DrKingsport, TN 37660-4657 · (423) 392-6343
Phone(423) 392-6343
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 2002
Enumeration DateDecember 5, 2007
Last NPPES UpdateMarch 8, 2012
✔ NPI 1902088644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in TN · MD0000039760
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
2204 PAVILION DR, Kingsport, TN 37660
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James W Denham 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 ID3870755804
PECOS Enrollment IDI20120508000555
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.

Medicare Billing Reassignments

3

Medicare enrollment records show James Denham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sullivan And Ptrs
Same address
Gastroenterology
2204 PAVILION DR STE 108
Kingsport, TN 37660
  • Reassigned Medicare billing, Tennessee enrollment
  • 5 clinicians in this Medicare group
NPI 1003981093 (423) 392-6100
Tri-Cities Gastroenterology LLC
7.4 mi
Gastroenterology
10461 WALLACE ALLEY ST
Kingsport, TN 37663
  • Reassigned Medicare billing, Tennessee enrollment
  • 7 clinicians in this Medicare group
NPI 1083639918 (423) 279-1400
Gastrointestinal Associates Of Northeast Tennessee, PC
19 mi
Gastroenterology
310 N STATE OF FRANKLIN RD, SUITE 202
Johnson City, TN 37604
  • Reassigned Medicare billing, Tennessee enrollment
  • 24 clinicians in this Medicare group
NPI 1578529632 (423) 929-7111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
2,833 services1,292 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
354 services325 patients
Special stained specimen slides to identify organisms including interpretation and report 88312
This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.
145 services130 patients

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost100

Other Providers at the Same Location NPPES 15

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

MS. JOANNE RICE CRNA
Nurse Anesthetist, Certified Registered
2204 PAVILION DR, SUITE 105
KINGSPORT, TN 37660
Sullivan County (423) 392-6100
REBECCA JANE HAMILTON NP
Nurse Practitioner
2204 PAVILION DR, SUITE 108
KINGSPORT, TN 37660
Sullivan County (423) 392-6100
MRS. LAUREN AMBROSIA DALEY NP
Nurse Practitioner
2204 PAVILION DR, SUITE 108
KINGSPORT, TN 37660
Sullivan County (423) 392-6100
KELLY G MCQUEEN DO
Family Medicine
2204 PAVILION DR, SUITE 310
KINGSPORT, TN 37660
Sullivan County (423) 224-3900
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Pediatrics
2204 PAVILION DR, SUITE 210
KINGSPORT, TN 37660
Sullivan County (423) 224-3933
WILLIAM J STEPTOE MD
Internal Medicine
2204 PAVILION DR, SUITE 310
KINGSPORT, TN 37660
Sullivan County (423) 224-3900
JAMES BRADLEY GAITHER CRNA
Nurse Anesthetist, Certified Registered
2204 PAVILION DR, SUITE 105
KINGSPORT, TN 37660
Sullivan County (423) 392-6343
ANITA ARMARAM ALWANI MD
Internal Medicine
2204 PAVILION DR, 200
KINGSPORT, TN 37660
Sullivan County (423) 246-0703

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 James Denham's NPI number?

The NPI number for James Denham is 1902088644. It was assigned to this individual provider in the NPPES registry on December 5, 2007.

Where is James Denham located?

James Denham practices at 2204 Pavilion Dr, Kingsport, TN 37660. The listed phone number is (423) 392-6343.

What is James Denham's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is James Denham enrolled in Medicare?

Yes. James Denham 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.

Which organizations bill Medicare for James Denham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Denham reassigns Medicare benefits to 3 organizations: Sullivan And Ptrs (Kingsport, TN), Tri-Cities Gastroenterology LLC (Kingsport, TN) and Gastrointestinal Associates Of Northeast Tennessee, PC (Johnson City, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Denham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Denham accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list James Denham 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.

When was this NPI record last updated?

The NPPES record for James Denham was last updated on March 8, 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.