BLUE RIDGE NEUROLOGY ASSOCIATES P.C. (NPI# 1639190846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639190846 |
| Entity Type | Organization |
| Organization Name | BLUE RIDGE NEUROLOGY ASSOCIATES P.C. |
| Practice Address |
2012 Brookside Dr Ste. 8 Kingsport TN 37660-4645 |
| Practice Telephone | 4232244183 |
| Practice Fax Number | 4232244180 |
| Mailing Telephone | 4232244183 |
| Mailing Fax Number | 4232244180 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL S DEW (DOCTOR) |
| Authorized Official Telephone | 4232244183 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | MD20022 | TN | Other Service Providers |
| Y | 174400000X | Specialist | MD26480 | TN | Other Service Providers |
| Street Address |
2012 BROOKSIDE DR STE. 8 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366437154 | Joe Howard Owens | Podiatrist | 2012 Brookside Dr, Suite 9, Kingsport, TN 37660-4645 | 2005-09-17 |
| 1083936033 | Mountain States Health Alliance Out-patient Behavioral Health | Psychologist | 2012 Brookside Dr, Kingsport, TN 37660-4645 | 2010-02-18 |
| 1912178112 | Kingsport Plastic Surgery, PC | Surgery | 2012 Brookside Dr, Suite 1, Kingsport, TN 37660-4645 | 2008-03-14 |
| 1053479139 | Lesley Ann Jones | Family Medicine | 2012 Brookside Dr, Ste 6, Kingsport, TN 37660-4645 | 2006-12-04 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391012 | Chelsey Bishop | Specialist | 400 Blue Haven Dr, Kingsport, TN 37663-3043 | 2017-04-23 |
| 1326397910 | Simpson Clinic, LLC | Specialist | 2012 Brookside Drive, Suite 8, Kingsport, TN 37660 | 2012-08-29 |
| 1639343734 | K. G. Porter, Md, LLC | Specialist | 1936 Brookside Dr Ste C, Kingsport, TN 37660-4654 | 2008-04-18 |
| 1760593834 | Premier Anesthesia Services PC | Specialist | 2000 Brookside Drive, Suite 207, Kingsport, TN 37660-4627 | 2006-08-31 |
| 1043228646 | Randall J Falconer Md PC | Specialist | 1728 N Eastman Road, Kingsport, TN 37664 | 2006-08-03 |
| 1235197815 | W Jan Kazmier | Specialist | 2995 Fort Henry Dr, Suite 100, Kingsport, TN 37664-4005 | 2006-05-03 |
| 1649641200 | Sam W. Huddleston Iv Md PC | Specialist | 2002 Brookside Dr, Suite# 201, Kingsport, TN 37660-4634 | 2015-10-08 |
| 1346686763 | Blue Ridge Medical Management Corporation | Specialist | 2002 Brookside Dr, Suite 300a, Kingsport, TN 37660-4634 | 2013-05-13 |
| 1730395153 | Donna Howard Crotts | Specialist | 130 W Ravine Rd, Kingsport, TN 37660-3810 | 2007-05-15 |
| 1932312337 | Heather Christine Wallen | Specialist | 1041 East Sullivan Street, Kingsport, TN 37660 | 2007-05-08 |
| 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.