KIMBERLY D ROLLER (NPI# 1457544868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457544868 |
| Entity Type | Individual |
| Full Name | KIMBERLY D ROLLER |
| Credential | MD |
| Practice Address |
101 Professional Park Pvt Dr Kingsport TN 37663-2288 |
| Practice Telephone | 4232397300 |
| Practice Fax Number | 4232398581 |
| Mailing Telephone | 4232397300 |
| Mailing Fax Number | 4232398581 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2016-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 0101244717 | VA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 50121 | TN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101244717 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1515804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629616172 | Kimberly M Roller | Behavioral Analyst | 2222 Schiller Rd, Emmett, ID 83617-9747 | 2019-12-16 |
| Street Address |
101 PROFESSIONAL PARK PVT DR |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37663-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508877846 | Roger Archer | Family Medicine | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2006-08-11 |
| 1659907327 | Mountain Region Family Medicine, PC | Family Medicine | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2020-03-13 |
| 1205205317 | Monna J. Nelms | Nurse Practitioner | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2015-09-18 |
| 1033537428 | Amanda Malone | Nurse Practitioner | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2014-04-02 |
| 1710990601 | Mountain Region Family Medicine, PC | Family Medicine | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2006-08-14 |
| 1265443436 | Richard L Brandon | Family Medicine | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649528126 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 1567 North Eastman Road, Kingsport, TN 37663 | 2012-08-15 |
| 1548546419 | Vickie R Harris | Counselor | 317 Pitt Road, Kingsport, TN 37663 | 2011-10-24 |
| 1467746446 | Eric A. Echard | Dentist | 1339 Moreland Drive, Suite 1, Kingsport, TN 37663 | 2011-06-07 |
| 1619003399 | Colonial Heights Pharmacy, Inc. | Pharmacy | 4221 Ft. Henry Drive, Kingsport, TN 37663 | 2007-02-26 |
| 1316005986 | Robert F Mcamis Jr. | Dentist | 4016 Fort Henry Drive, Kingsport, TN 37663 | 2006-12-05 |
| 1467567412 | Colonial Heights Dental Assocaites | Dentist | 150 Clinic Drive, Suite A, Kingsport, TN 37663 | 2006-08-20 |
| 1194777953 | Nicholas Brett Smith | Family Medicine | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2006-05-17 |
| 1396720108 | Resp-i-care, Inc. | Durable Medical Equipment & Medical Supplies | 648 Eastern Star Rd, Kingsport, TN 37663 | 2005-12-14 |
| 1023000429 | Darryl Fontaine | Anesthesiology | 4105 Fort Henry Drive, Suite 207, Kingsport, TN 37663 | 2005-08-22 |
| 1659701696 | Jordan Burke | Physician Assistant | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2013-11-12 |
| Find all providers in zip 37663 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563455 | Kathleen Barksdale Beine | Family Medicine | 4515 Brookridge Dr, Kingsport, TN 37664-2105 | 2020-06-24 |
| 1861768350 | Jennifer Lynn Woodard | Family Medicine | 415 Broad St Ste 410, Kingsport, TN 37660-4264 | 2012-03-28 |
| 1588786768 | Medical Education Assistance Corporation | Family Medicine | 102 Ravine Rd, Ste 1, Kingsport, TN 37660 | 2007-04-06 |
| 1659450096 | Tihomir Ivanov Tochev | Family Medicine | 1501 E Stone Dr, Kingsport, TN 37660-4132 | 2006-11-05 |
| 1508877846 | Roger Archer | Family Medicine | 101 Professional Park Pvt Dr, Kingsport, TN 37663-2288 | 2006-08-11 |
| 1285664839 | Scott D Mclain | Family Medicine | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2006-07-03 |
| 1295778538 | Centerpoint Medical Clinic LLC | Family Medicine | 2020 Brookside Drive, Suite 20, Kingsport, TN 37660 | 2006-06-14 |
| 1194777953 | Nicholas Brett Smith | Family Medicine | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2006-05-17 |
| 1396796173 | Daniel L Dickerson | Family Medicine | 208 Lynn Garden Dr, Ste 2, Kingsport, TN 37660-3171 | 2006-05-15 |
| 1174509533 | Joann W. D'aprile-lubrano | Family Medicine | 444 Clinchfield St, Suite 201, Kingsport, TN 37660-3606 | 2005-12-19 |
| 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.