TRI-CITIES REGIONAL EMERGENCY PHYSICIANS, PC – Emergency Medicine Physician, NPI 1063950046
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TRI-CITIES REGIONAL EMERGENCY PHYSICIANS, PC
1 Medical Park Blvd
Bristol, TN 376207453
Phone: (423) 844-1121
Fax: (423) 844-4202
Type: Location
1420 Tusculum Blvd
Greeneville, TN 377454279
Phone: (423) 787-5000
Fax: (423) 787-5083
Type: Location
1519 Main St
Sneedville, TN 378693657
Phone: (423) 733-5000
Fax: (423) 733-5093
Type: Location
1501 W Elk Ave
Elizabethton, TN 376432854
Phone: (423) 542-1300
Fax: (423) 543-5372
Type: Location
1901 S Shady St
Mountain City, TN 376832021
Phone: (423) 727-1100
Fax: (423) 727-4993
Type: Location
300 MedTech Parkway
Johnson City, TN 37604
Phone: (423) 302-1000
Fax: (423) 302-1237
Type: Location
130 W Ravine Rd
Kingsport, TN 376603837
Phone: (423) 224-4000
Fax: (423) 224-5016
Type: Location
851 Locust St
Rogersville, TN 378572407
Phone: (423) 921-7000
Fax: (423) 921-7002
Type: Location
2000 Brookside
Kingsport, TN 376604627
Phone: (423) 857-7000
Fax: (423) 392-7557
Type: Location
Corporate Boulevard, Lafayette, Lafayette Parish, Louisiana, 70502, United States
LAFAYETTE, LA 705083870
Phone: (800) 893-9698
Type: Mailing
Johnson City Medical Center, 400, North State of Franklin Road, The Y, Johnson City, Washington County, Tennessee, 37604, United States
JOHNSON CITY, TN 376046035
Phone: (423) 431-6111
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: 2017-04-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170410002399 | O | Clinic/Group Practice | TN | TBD |
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.
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 37620)
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