WELLMONT CARDIOLOGY SERVICES (NPI# 1376575035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376575035 |
| Entity Type | Organization |
| Organization Name | WELLMONT CARDIOLOGY SERVICES |
| Practice Address |
2050 Meadowview Parkway Kingsport TN 37660-7332 |
| Mailing Address |
2050 Meadowview Pkwy Kingsport TN 37660-7475 |
| Practice Telephone | 4232305000 |
| Practice Fax Number | 4232305097 |
| Mailing Telephone | 4232305000 |
| Mailing Fax Number | 4232305035 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-05-05 |
| Authorized Official Name | GERALD BLACKWELL (SYSTEM PRESIDENT) |
| Authorized Official Telephone | 4232305000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1376575035 | 05 | |
| VA | RAILROAD MEDICARE | DR8098 | 01 |
| TN | 3382171 | 05 | |
| TN | 3382170 | 05 | |
| TN | RAILROAD MEDICARE | DR5963 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356669568 | Wellmont Cardiology Services | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7332 | 2010-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WELLMONT CARDIOLOGY SERVICES | 1 Medical Park Blvd Ste 458w, Bristol, TN 37620-7456 |
| Virginia Business Entities | Wellmont Cardiology Services | 1905 American Way, Kingsport, Tennessee 37660 |
| Street Address |
2050 MEADOWVIEW PARKWAY |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-7332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992795066 | Pabitra K Saha | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2005-10-28 |
| 1164681607 | Rahul Sakhuja | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2008-06-09 |
| 1710098546 | Marc W Mayhew | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-08-31 |
| 1073539078 | Daniel E Simpson | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-14 |
| 1811920630 | Harrison D Turner | Specialist | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-07 |
| 1790717429 | James J Merrill | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-06 |
| 1730119272 | Gregory K Jones | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-03 |
| 1174552467 | Herbert D Ladley | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-01 |
| 1689600587 | Gerald G Blackwell | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-06-23 |
| 1427084342 | John R Bertuso | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-06-23 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1992795066 | Pabitra K Saha | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2005-10-28 |
| 1912139411 | Judd Thomas Salamat | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2009-08-17 |
| 1407003403 | Mark Aziz | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2008-08-20 |
| 1356553648 | Freddie Maxine Williams | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7332 | 2007-05-07 |
| 1437245636 | Keith Aaron Kyker | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2006-10-05 |
| 1780780882 | Robert Hughes Mcqueen | Internal Medicine | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-09-15 |
| 1073539078 | Daniel E Simpson | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-14 |
| 1629002043 | Marc D Counts | Internal Medicine | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2006-07-10 |
| 1154354033 | Larry T Breeding | Internal Medicine | 2205 Pavilion Dr, Suite 201, Kingsport, TN 37660-4641 | 2006-07-07 |
| 1730119272 | Gregory K Jones | Internal Medicine | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-03 |
| Find all providers in KINGSPORT | ||||
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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.