LEGACY VEIN CENTER PLLC (NPI# 1477972933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477972933 |
| Entity Type | Organization |
| Organization Name | LEGACY VEIN CENTER PLLC |
| Practice Address |
109 Jack White Dr Kingsport TN 37664-2364 |
| Practice Telephone | 4232452078 |
| Mailing Telephone | 4232452078 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |
| Authorized Official Name | BEN ROGERS (MANAGER) |
| Authorized Official Telephone | 4232452078 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | LEGACY VEIN CENTER PLLC | 310 N State of Franklin Rd Ste 103, Johnson City, Tennessee 37604-6063 |
| Street Address |
109 JACK WHITE DR |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664-2364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386085132 | Premier Pharmacy Inc | Pharmacy | 109 Jack White Dr, Kingsport, TN 37664-2364 | 2013-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1861966525 | Catherine Ann Hensley | Nurse Practitioner | 2995 Fort Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-16 |
| 1679076954 | Christopher A Hillman | Dentist | 1599 Fort Henry Dr Ste 102, Kingsport, TN 37664 | 2018-03-13 |
| 1154666733 | Cristin Patterson | Counselor | 2762 East Center St., Kingsport, TN 37664 | 2012-12-07 |
| 1972851095 | Kevin Michael Smith | Pharmacist | 1425 East Center Street, Kingsport, TN 37664 | 2012-08-21 |
| 1619299617 | Kelli Lynn Dillon | Counselor | 1570 Waverly Rorad, Kingsport, TN 37664 | 2010-02-18 |
| 1356503726 | Charles Craig Stieler | Hearing Instrument Specialist | 2101 Ft Henry Dr, Kingsport, TN 37664 | 2008-06-27 |
| 1104012319 | Pro Balance LLC | Prosthetic/Orthotic Supplier | 2408 Fort Henry Drive, Kingsport, TN 37664 | 2007-09-20 |
| 1518188648 | Remington House | Assisted Living Facility | 640 Rock Springs Road, Kingsport, TN 37664 | 2007-05-02 |
| 1689795007 | Elaine Frazier | Emergency Medicine | 410 Golf Ridge Dr, Kingsport, TN 37664 | 2007-04-03 |
| Find all providers in zip 37664 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982635553 | Howard Thomas Brock | Surgery | 914 Broad St, Ste 2a, Kingsport, TN 37660-3817 | 2006-07-05 |
| 1417990730 | Kelly S Oggero | Surgery | 444 Clinchfield St Ste 2900, Kingsport, TN 37660-3858 | 2006-06-14 |
| 1659364602 | John R Hall | Surgery | 1833 Buckingham Ct, Kingsport, TN 37660-5871 | 2005-08-25 |
| 1407299324 | Grace Lucta Ward | Surgery | 105 W Stone Dr, Kingsport, TN 37660 | 2013-04-10 |
| 1417215195 | Stephanie Anne Hart | Surgery | 444 Clinchfield St Ste 2900, Kingsport, TN 37660-3858 | 2012-05-01 |
| 1578791307 | Robert Charles Allen | Surgery | 2050 Meadowview Pkwy, Kingsport, TN 37660-7475 | 2009-07-01 |
| 1386870285 | Elizabeth Michele Jackson | Surgery | 444 Clinchfield St, Suite 2900, Kingsport, TN 37660-3606 | 2009-06-05 |
| 1316164288 | John Stewart Keeley Jr. | Surgery | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2007-04-20 |
| 1841369402 | John Albert Ehrenfried | Surgery | 444 Clinchfield Street, Suite 2900, Kingsport, TN 37660 | 2006-11-07 |
| 1205844024 | Andrew Phillip Kramer | Surgery | 444 Clinchfield Street, Suite 2900, Kingsport, TN 37660 | 2006-08-04 |
| Find all providers in KINGSPORT | ||||
Please comment or provide details below to improve the information on LEGACY VEIN CENTER PLLC.
| 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.