ENDOSCOPY CENTER OF KINGSPORT (NPI# 1235140385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235140385 |
| Entity Type | Organization |
| Organization Name | ENDOSCOPY CENTER OF KINGSPORT |
| Other Organization Name | SULLIVAN DIGESTIVE CENTER |
| Practice Address |
2204 Pavilion Dr Suite 108 Kingsport TN 37660-4657 |
| Practice Telephone | 4233926100 |
| Practice Fax Number | 4233926159 |
| Mailing Telephone | 4233926100 |
| Mailing Fax Number | 4233926159 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2010-07-01 |
| Authorized Official Name | MS. PENNY LEIGH VAUGHN (ADMINISTRATOR) |
| Authorized Official Telephone | 4233926100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
0000000053 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3287396 | 05 |
| Other Name | Type Code |
|---|---|
| Sullivan Digestive Center | Doing Business As Name - Organization |
| Street Address |
2204 PAVILION DR SUITE 108 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245226737 | Rebecca Jane Hamilton | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2005-09-21 |
| 1720468200 | Mountain States Health Alliance | General Acute Care Hospital | 2204 Pavilion Dr, Suite 115, Kingsport, TN 37660-4657 | 2015-06-01 |
| 1821402728 | Sullivan Specialty Pharmacy | Pharmacy | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2014-06-18 |
| 1568703437 | Lauren Musick | Pharmacist | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2013-03-02 |
| 1316228075 | Clinchfield Family Medicine, Pllc | Clinic/Center | 2204 Pavilion Dr, Suite 110, Kingsport, TN 37660-4657 | 2011-09-07 |
| 1619265550 | Tennessee Anesthesiology LLC | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2011-07-13 |
| 1396049938 | Blue Ridge Medical Management Corporation | Pediatrics | 2204 Pavilion Dr, Suite 210, Kingsport, TN 37660-4657 | 2010-12-22 |
| 1730401209 | Blue Ridge Medical Management Corporation | Family Medicine | 2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653 | 2010-02-24 |
| 1518289206 | James Bradley Gaither | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2010-02-22 |
| 1265763668 | Lauren Ambrosia Daley | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2010-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063437994 | Tri-cities Endoscopy Center PC | Clinic/Center | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760467732 | G I Diagnostic and Therapeutic Center LLC | Clinic/Center | 1310 Wolf Park Dr, Germantown, TN 38138-1741 | 2005-12-13 |
| 1821082702 | Clarksville Endoscopy Center | Clinic/Center | 132 Hillcrest Dr, Clarksville, TN 37043-5000 | 2005-09-07 |
| 1770859738 | Clarksville Endoscopy Center LLC | Clinic/Center | 132 Hillcrest Dr, Clarksville, TN 37043-5000 | 2012-03-23 |
| 1174859516 | Hermitage Tn Endoscopy Asc, LLC | Clinic/Center | 5653 Frist Blvd, Suite 532, Hermitage, TN 37076-2062 | 2009-10-20 |
| 1326176215 | Nashville Gastrointestinal Specialists, LLC | Clinic/Center | 4230 Harding Road, Suite 309w, Nashville, TN 37205-2013 | 2007-03-01 |
| 1801923636 | Nashville Gastrointestinal Specialists, LLC | Clinic/Center | 2010 Church Street, Suite 420, Nashville, TN 37203-2012 | 2007-02-28 |
| 1790811222 | Nashville Gastroenterology and Hepatology, PC | Clinic/Center | 330 Wallace Rd, Suite 103, Nashville, TN 37211-4893 | 2007-02-26 |
| 1831249341 | Endoscopy Center of The Mid-south, LLC | Clinic/Center | 3960 Knight Arnold Rd, Suite 117, Memphis, TN 38118-3035 | 2007-01-10 |
| 1326142878 | Lebanon Endoscopy Center LLC | Clinic/Center | 100 Physicians Way, Suite 340, Lebanon, TN 37090-8103 | 2006-09-12 |
| 1982718524 | Gastrointestinal Specialists of Clarksville, PC | Clinic/Center | 280 Warfield Blvd, Clarksville, TN 37043-1828 | 2006-08-19 |
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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.