Endoscopy Center of Northeast Tennessee, PC
NPI 1164488219 · Ambulatory Surgical Clinic/Center · Johnson City, TN
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Endoscopy Center of Northeast Tennessee, PC is a Ambulatory Surgical Clinic/Center organization in Johnson City, TN (NPI 1164488219).
Provider details
- NPI number
- 1164488219
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Penny Rutledge, Facility Administrator(423) 929-7111
- License
- 0000000056 (TN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,776 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Biopsy of Large Bowel Using a Flexible Endoscope45380 | 404 | $453 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 396 | $310 |
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 357 | $526 |
| Colorectal Cancer Screening; Colonoscopy on Individual at High RiskG0105 | 152 | $410 |
| Dilation of Esophagus43450 | 120 | $384 |
| Diagnostic Exam of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope |
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-04-25
- Last updated
- 2020-08-22
Frequently asked questions
- What is Endoscopy Center of Northeast Tennessee, PC's NPI number?
- Endoscopy Center of Northeast Tennessee, PC's National Provider Identifier (NPI) is 1164488219, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Endoscopy Center of Northeast Tennessee, PC?
- Endoscopy Center of Northeast Tennessee, PC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Endoscopy Center of Northeast Tennessee, PC located?
- Endoscopy Center of Northeast Tennessee, PC's practice location on file with NPPES is 310 N State of Franklin Rd, Johnson City, TN 37604-6008.
- What is Endoscopy Center of Northeast Tennessee, PC's phone number?
- The practice phone number listed in the NPPES registry for Endoscopy Center of Northeast Tennessee, PC is (423) 929-7111.
- Does Endoscopy Center of Northeast Tennessee, PC accept Medicare?
- Endoscopy Center of Northeast Tennessee, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Endoscopy Center of Northeast Tennessee, PC?
- The authorized official listed on Endoscopy Center of Northeast Tennessee, PC's NPPES record is Penny Rutledge, Facility Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Endoscopy Center of Northeast Tennessee, PC's NPI active?
- Yes — Endoscopy Center of Northeast Tennessee, PC's NPI (1164488219) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.