KINGSPORT PRIMARY HEALTHCARE, LLC (NPI# 1679074892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679074892 |
| Entity Type | Organization |
| Organization Name | KINGSPORT PRIMARY HEALTHCARE, LLC |
| Practice Address |
1526 Bridgewater Ln Kingsport TN 37660-4106 |
| Mailing Address |
4980 Randel Rd Oneida NY 13421-3515 |
| Practice Telephone | 4232460033 |
| Practice Fax Number | 4232450034 |
| Mailing Telephone | 3153636325 |
| Mailing Fax Number | 3153636325 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | STAN MCLAIN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3133636325 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD39507 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1526 BRIDGEWATER LN |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285664839 | Scott D Mclain | Family Medicine | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2006-07-03 |
| 1861015992 | Matthew Grimm | Nurse Practitioner | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2020-05-23 |
| 1023186145 | Kingsport Primary Care, PC | Clinic/Center | 1526 Bridgewater Ln, Kingsport, TN 37660-4106 | 2006-11-30 |
| 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 | 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 | ||||
Please comment or provide details below to improve the information on KINGSPORT PRIMARY HEALTHCARE, LLC.
| 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.