WELLMONT PHYSICIAN SERVICES INC (NPI# 1336267145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336267145 |
| Entity Type | Organization |
| Organization Name | WELLMONT PHYSICIAN SERVICES INC |
| Practice Address |
1 Medical Park Blvd Suite 200e Bristol TN 37620-7430 |
| Mailing Address |
999 Executive Park Blvd Suite 201 Kingsport TN 37660-4632 |
| Practice Telephone | 4238445100 |
| Practice Fax Number | 4238445109 |
| Mailing Telephone | 4232243250 |
| Mailing Fax Number | 4232243258 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2010-04-16 |
| Authorized Official Name | CINDY M LOCKE (BILLING ADMINISTRATOR) |
| Authorized Official Telephone | 4232243250 |
| Authorized Official Credential | CPC CCS-P |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | FEDERAL BLACK LUNG | 023305000 | 01 |
| VA | UMWA | 1535526 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972785855 | Wellmont Physician Services Inc | Clinic/Center | 415 Hwy 610 W, Suite 100, Virgie, KY 41572 | 2007-12-03 |
| 1770753444 | Wellmont Physician Services Inc | Non-Pharmacy Dispensing Site | 111 W Stone Dr, Suite 300, Kingsport, TN 37660-6027 | 2008-03-10 |
| 1275710063 | Wellmont Physician Services Inc | Surgery | 9480 Highway 805, Jenkins, KY 41537-8182 | 2008-01-24 |
| 1942482849 | Wellmont Physician Services Inc | General Practice | 905 W Russell St, Elkhorn City, KY 41522-7071 | 2007-12-03 |
| 1043339385 | Wellmont Physician Services Inc | Obstetrics & Gynecology | 1980 Holton Ave E, Suite 301, Big Stone Gap, VA 24219-3366 | 2007-03-28 |
| 1366560161 | Wellmont Physician Services Inc | Otolaryngology | 1 Cloverleaf Sq, Suite F1, Big Stone Gap, VA 24219-2758 | 2007-03-27 |
| 1194843961 | Wellmont Physician Services Inc | Internal Medicine | 280 Virginia Ave Ne, Suite 107, Norton, VA 24273-1538 | 2007-03-27 |
| 1346368115 | Wellmont Physician Services Inc | Nurse Practitioner | 295 Wharton Ln Ne, Norton, VA 24273-1541 | 2007-03-27 |
| 1114045903 | Wellmont Physician Services Inc | Internal Medicine | 611 Trent St Ne, Norton, VA 24273-1533 | 2007-03-27 |
| 1619095403 | Wellmont Physician Services Inc | Anesthesiology | 1990 Holton Ave E, Big Stone Gap, VA 24219-3350 | 2007-03-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Wellmont Physician Services Inc. | 1905 American Way, Kingsport, Tennessee 37660 |
| Street Address |
1 MEDICAL PARK BLVD SUITE 200E |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-7430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598768699 | Medical Mall Pharmacy Inc | Pharmacy | 1 Medical Park Blvd, Suite 106-e, Bristol, TN 37620-7430 | 2005-05-23 |
| 1225640980 | Amanda Marshall | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7453 | 2020-08-23 |
| 1336764406 | Maggie Mullins | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-14 |
| 1578188249 | Angela Dawn Owens | Pharmacist | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-09 |
| 1528683133 | Jessica Dawn Anderson | Registered Nurse | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-06-09 |
| 1659904837 | Sarah Elizabeth Smith | Nurse Anesthetist, Certified Registered | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2020-02-17 |
| 1063055762 | Chelsea Newsome | Nurse Practitioner | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-10-25 |
| 1750943718 | Sara Anne Mcglothlin | Occupational Therapy Assistant | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-06-30 |
| 1801355359 | Aaron Allen Kelley | Respiratory Therapist, Registered | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2019-03-14 |
| 1164922076 | Neha D Naik | Pharmacist | 1 Medical Park Blvd, Bristol, TN 37620-7430 | 2018-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881219863 | Eahab Abdul-lattif | Internal Medicine | 500 Bath Road, Bristol, PA 19007 | 2020-06-15 |
| 1043856677 | Pac of Tennessee PC | Internal Medicine | 1958 West State Street, Suite 2, Bristol, TN 37620-2257 | 2019-11-19 |
| 1992157903 | Aiman Riaz | Internal Medicine | 41 Brewster Rd # 5161, Bristol, CT 06010 | 2016-07-01 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| 1679879118 | Ravikumar Patel | Internal Medicine | 1 Medical Park Blvd Ste 255w, Bristol, TN 37620-7430 | 2011-02-01 |
| 1528274859 | Holly Amber Berndt | Internal Medicine | 1 Medical Park Blvd Ste 350w, Bristol, TN 37620-7471 | 2007-05-15 |
| 1396871422 | Basharat A. Shah | Internal Medicine | 1 Medical Park Blvd., Bristol Regional Medical Center, Bristol, TN 37620 | 2007-02-25 |
| 1114063948 | Wendie M Puls | Internal Medicine | 30 Mountain St, Bristol, VT 05443-1310 | 2007-01-29 |
| 1467520114 | Dorcas B Goodman | Internal Medicine | 11033 Nw State Road 20, Bristol, FL 32321-6406 | 2006-12-01 |
| 1235222506 | John Arthur Frazier | Internal Medicine | 123 Maple St, Bristol, CT 06010-5037 | 2006-10-01 |
| Find all providers in BRISTOL | ||||
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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.