DR. CLINT DANIEL KINGSLEY (NPI# 1053348037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053348037 |
| Entity Type | Individual |
| Full Name | DR. CLINT DANIEL KINGSLEY |
| Credential | MD |
| Practice Address |
1032 Mccallie Ave Ste 200 Chattanooga TN 37403-2836 |
| Mailing Address |
Po Box 440100 Nashville TN 37244-0100 |
| Practice Telephone | 4237525004 |
| Practice Fax Number | 4234143834 |
| Mailing Telephone | 6153290570 |
| Mailing Fax Number | 6153290579 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
49477 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 104703 | 05 | |
| AL | BCBS OF ALABAMA | 510-50070 | 01 |
| AL | BLUE CROSS OF ALABAMA | 51547906 | 01 |
| AL | RR MEDICARE | CA0084 | 01 |
| AL | MEDICARE NUMBER | 510I110169 | 01 |
| AL | RR MEDICARE NUMBER | P00657989 | 01 |
| TN | 1528883 | 05 | |
| AL | 102961 | 05 | |
| AL | BLUE CROSS OF ALABAMA | 51012794 | 01 |
| AL | 528701110 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1208 Pointe Centre Dr Ste 110, Chattanooga, TN 374213989 | 4232664764 | 4234143835 |
| 2200 E 3rd St Ste 100, Chattanooga, TN 374042724 | 4236482388 | 4236482390 |
| Street Address |
1032 MCCALLIE AVE STE 200 |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37403-2836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386609394 | Larry L Schlabach | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2006-04-20 |
| 1235741638 | Tennessee Oncology, Pllc | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2020-08-18 |
| 1619107414 | Sumana Nagireddy | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2009-07-15 |
| 1285823658 | Harsha Gadadhar Vardhana | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2007-10-22 |
| 1306068135 | Robert Matthew Graham | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2007-05-02 |
| 1811952831 | John W Mccravey | Internal Medicine | 1032 Mccallie Ave Ste 200, Chattanooga, TN 37403-2836 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033771332 | Jaimie Mills | Specialist/Technologist | 103 Metropolitan Building, Chattanooga, TN 37403 | 2019-07-08 |
| 1972092849 | Joshua Dale Gebhardt | Marriage & Family Therapist | 1024 East M L King Blvd, Chattanooga, TN 37403 | 2018-05-07 |
| 1528580750 | Klifford Hawkins | Physical Therapist | 1100 E 3rd St Ste G103, Chattanooga, TN 37403 | 2017-07-10 |
| 1861921470 | Jonathan Everett Burden | Student in an Organized Health Care Education/Training Program | 960 E 3rd St Ste 104, Chattanooga, TN 37403 | 2017-06-07 |
| 1992167092 | Majel Victoria Purvis Miles | Student in an Organized Health Care Education/Training Program | 979 E 3rd St Ste 401, Chattanooga, TN 37403 | 2016-03-28 |
| 1972942902 | Danielle Nessly | Nurse Practitioner | 730 East 11th Street, Chattanooga, TN 37403 | 2013-06-24 |
| 1023453271 | Nathan Claydon | Internal Medicine | 960 East 3rd St, Suite 104, Chattanooga, TN 37403 | 2013-05-01 |
| 1336482603 | Veronica Patterson Zachry | Student in an Organized Health Care Education/Training Program | 975 E. 3rd Street, Chattanooga, TN 37403 | 2013-04-04 |
| 1639420417 | Ctr. for Individual & Family Effectiveness | Community/Behavioral Health | 310 E. 8th St., Ste. C, Chattanooga, TN 37403 | 2012-09-20 |
| 1063773521 | Shelley L Murphy | Emergency Medicine | 1018 Blackford Street, Chattanooga, TN 37403 | 2012-05-31 |
| Find all providers in zip 37403 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780632687 | Edward R. Arrowsmith | Internal Medicine | 605 Glenwood Avenue, Suite 200, Chattanooga, TN 37404-1130 | 2006-05-04 |
| 1356306443 | Chatt. Hamilton County Hospital Authority D/b/a Cancer Care Chatt. | Internal Medicine | 979 East Third Street, Suite A-0540/a-0550, Chattanooga, TN 37403 | 2006-04-20 |
| 1194711499 | Russell A Jones | Internal Medicine | 605 Glenwood Dr, Suite 200, Chattanooga, TN 37404-1130 | 2005-09-22 |
| 1679082440 | Melissa Lynn Miller | Internal Medicine | 6393 Lee Hwy, Chattanooga, TN 37421-2569 | 2017-09-25 |
| 1023458403 | Tennessee Cancer Specialists | Internal Medicine | 2525 Desales Avenue, Chattanooga, TN 37414-1102 | 2013-06-28 |
| 1689910986 | Tennessee Oncology, Pllc | Internal Medicine | 2200 E 3rd St, Suite 100, Chattanooga, TN 37404-2744 | 2012-12-14 |
| 1437494861 | Tennessee Oncology, Pllc | Internal Medicine | 605 Glenwood Dr, Suite 200, Chattanooga, TN 37404-1108 | 2012-12-12 |
| 1003163288 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 975 E 3rd St, Erlinger Medical Center, Chattanooga, TN 37403-2147 | 2012-08-07 |
| 1154612695 | Chattanooga Oncology and Hematology Associates | Internal Medicine | 605 Glenwood Dr Ste 200, Chattanooga, TN 37404-1130 | 2011-05-02 |
| 1255575270 | Gregory Ryan Sutton | Internal Medicine | 2200 E 3rd St, Suite 100, Chattanooga, TN 37404-2744 | 2009-04-21 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.