PHILLIP GLASS MD
NPI 1962023051
Psychiatry & Neurology - Psychiatry in Johnson City, TN

Q: What is Phillip Glass's NPI number?

The NPI number for Phillip Glass is 1962023051. It was assigned to this individual provider in the NPPES registry on April 30, 2020.

Q: What is Phillip Glass's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Glass was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 April 30, 2020PECOS EnrolledAccepts Medicare Assignment

403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604(423) 431-7111(423) 431-7092 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 12, 2026, Dec 29, 2025, Nov 4, 2024 (3 updates tracked since 2024).

On this page

About Phillip Glass Md NPPES

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

PHILLIP GLASS MD (NPI 1962023051) is an individual psychiatry provider in Johnson City, Tennessee, licensed in Tennessee (72291) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Sycamore Shoals Hospital, and maintains a secondary practice location in Mountain Home.

NPPES Registry Identity

NPI1962023051

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NamePHILLIP GLASSCredential: MD

Location Address403 N STATE OF FRANKLIN RDJohnson City, TN 37604-6034

Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 952-2111

Phone(423) 431-7111

Fax(423) 431-7092

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 30, 2020

Last NPPES UpdateJanuary 12, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 12, 2026

✔ NPI 1962023051 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in TN · 72291

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

403 N STATE OF FRANKLIN RD, Johnson City, TN 37604

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Secondary Practice Location 1

Location 1Building 52 Lake DriveMountain Home, TN 37684 · Phone (423) 439-8000 · Fax (423) 439-2200

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.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

Phillip Glass 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 ID8022541457

PECOS Enrollment IDI20241024000008

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 Reassignment

Medicare enrollment records show Phillip Glass reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Blue Ridge Medical Management Corporation

Same address

Psychiatry

403 N STATE OF FRANKLIN RD
Johnson City, TN 37604

Reassigned Medicare billing, Tennessee enrollment
496 clinicians in this Medicare group

NPI 1093120222 (423) 431-7047

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

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 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

$160.89 typical visit price

range $52.64 – $160.89

Typical copayment $40.22 (range $13.16 – $40.22)

Most-billed visit code 99205

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MOUNTAIN STATES HEALTH ALLIANCE

Psychiatric Unit