CENTERPOINTE MEDICAL CLINIC, LLC (NPI# 1396013140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396013140 |
| Entity Type | Organization |
| Organization Name | CENTERPOINTE MEDICAL CLINIC, LLC |
| Practice Address |
2020 Brookside Dr Suite 20 Kingsport TN 37660-4633 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 301 Los Angeles CA 90077-1726 |
| Practice Telephone | 4232477030 |
| Mailing Telephone | 3104749809 |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |
| Authorized Official Name | ELIZABETH KRELL (OWNER) |
| Authorized Official Telephone | 4232477030 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTERPOINTE MEDICAL CLINIC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
2020 BROOKSIDE DR SUITE 20 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962485870 | Ina Kay Bone | Nurse Practitioner | 2020 Brookside Dr, Suite 20, Kingsport, TN 37660-4633 | 2005-11-23 |
| 1275820599 | Stephanie Renee Roach | Nurse Practitioner | 2020 Brookside Dr, Suite 20, Kingsport, TN 37660-4633 | 2011-07-07 |
| 1316245137 | Jennifer Michelle Barham | Nurse Practitioner | 2020 Brookside Dr, Suite 29, Kingsport, TN 37660-4633 | 2011-03-02 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770753444 | Wellmont Physician Services Inc | Non-Pharmacy Dispensing Site | 111 W Stone Dr, Suite 300, Kingsport, TN 37660-6027 | 2008-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578181160 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 4220 Harding Pike Bldg Ste200, Nashville, TN 37205-2005 | 2020-07-09 |
| 1144849050 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 1750 Cedar Ln Ste 200, Tullahoma, TN 37388-4761 | 2020-04-10 |
| 1720607625 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 3443 Dickerson Pike Ste 760, Nashville, TN 37207-2527 | 2020-04-10 |
| 1710516901 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 504 22nd Ave E, Springfield, TN 37172-3754 | 2020-04-08 |
| 1700415981 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 2121 N Locust Ave Ste 2, Lawrenceburg, TN 38464-4454 | 2020-04-08 |
| 1922634575 | Dedicated Physicians Group of Tennessee, Pllc | Non-Pharmacy Dispensing Site | 2252 Lamar Ave, Memphis, TN 38114-6608 | 2020-03-16 |
| 1144855073 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 776 Weatherly Dr Ste A, Clarksville, TN 37043-8941 | 2020-03-11 |
| 1407481567 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 5073 Main St Ste 210, Spring Hill, TN 37174-2738 | 2020-03-10 |
| 1659906709 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 103 Physicians Way Ste 102, Lebanon, TN 37090-4132 | 2020-03-10 |
| 1346875309 | Tennessee Oncology Pharmacy Dispensing | Non-Pharmacy Dispensing Site | 353 New Shackle Island Rd Ste 204a, Hendersonville, TN 37075-2371 | 2020-03-10 |
| Find all providers with the same taxonomy | ||||
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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.