KYLE ALLAN HOPPER – Physician Assistant, NPI 1104677897

KYLE ALLAN HOPPER is a healthcare provider. based in Johnson city, Tennessee. specializing in PHYSICIAN ASSISTANT. The NPI Number for KYLE ALLAN HOPPER is 1104677897

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
KYLE ALLAN HOPPER
NPI
1104677897
Phone
Not provided
Address
531 CALVIN PHILLIPS DR
Enumeration Date
29 March 2024
Last Update Date
29 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6066760206
Graduation Year
2024 (2 years ago)
PAC ID
1658808787
Group Practice PAC ID
2567510464
Professional Enrollment ID
I20241231001259
Address ID
KY425032750SO305XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

Provider Addresses for KYLE ALLAN HOPPER

  • 531 CALVIN PHILLIPS DR

    JOHNSON CITY, TN 376016445

    Phone:

    Type: Mailing

  • 101 NETH DR

    MILLIGAN, TN 376823015

    Phone: (423) 461-8700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241231001259IPhysician AssistantKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567510464View full group profile
NameSpecialtyState
General SurgeryCO
U R O L O G YKY
Internal MedicineKY
Physician AssistantKY
Interventional Pain ManagementKY
Internal MedicineKY
Physician AssistantKY
Endocrinology, Internal MedicineKY
Nurse PractitionerKY
-KY

Reviews

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Frequently asked questions

How do I look up KYLE ALLAN HOPPER by NPI?
Use NPI 1104677897 when you need to reference KYLE ALLAN HOPPER in forms, claims, or directories.
Is KYLE ALLAN HOPPER's NPI currently valid?
The extract we use shows KYLE ALLAN HOPPER as active.
Does KYLE ALLAN HOPPER list a primary specialty?
If you are matching referrals, note Physician Assistant for KYLE ALLAN HOPPER. Clinical services aligned with this taxonomy classification.
What location metadata exists for KYLE ALLAN HOPPER?
The page summarizes Johnson City, Tennessee for KYLE ALLAN HOPPER; expand the address list for detail.
Is KYLE ALLAN HOPPER a real provider?
This page reflects official NPPES data for NPI 1104677897. Always confirm identity and privileges with the practice and licensing boards.

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