KINGSPORT PLASTIC SURGERY, PC (NPI# 1912178112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912178112 |
Entity Type | Organization |
Organization Name | KINGSPORT PLASTIC SURGERY, PC |
Practice Address |
2012 Brookside Dr Suite 1 Kingsport TN 37660-4645 |
Practice Telephone | 4232458400 |
Practice Fax Number | 4232459959 |
Mailing Telephone | 4232458400 |
Mailing Fax Number | 4232459959 |
Enumeration Date | 2008-03-14 |
Last Update Date | 2008-03-14 |
Authorized Official Name | KRISTY F LANE (PRACTICE ADMINISTRATOR) |
Authorized Official Telephone | 4232458400 |
Authorized Official Credential | CCP-P |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
25312 | TN | Allopathic & Osteopathic Physicians |
Street Address |
2012 BROOKSIDE DR SUITE 1 |
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 |
1053479139 | Lesley Ann Jones | Family Medicine | 2012 Brookside Dr, Ste 6, Kingsport, TN 37660-4645 | 2006-12-04 |
1639190846 | Blue Ridge Neurology Associates P.C. | Specialist | 2012 Brookside Dr, Ste. 8, Kingsport, TN 37660-4645 | 2006-07-22 |
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 | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770508525 | Samuel W Huddleston Iv | Surgery | 2002 Brookside Drive, Ste 201, Kingsport, TN 37660 | 2006-07-13 |
1841433059 | New Horizons Plastic Surgery LLC | Surgery | 2033 Meadowview Ln, Suite 110, Kingsport, TN 37660-7569 | 2009-04-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255829552 | Ahmed Al Bayati | Surgery | Medical Center North 1161 21st Avenue S Suite Ccc-4312, Nashville, TN 37232-0001 | 2018-04-23 |
1275039661 | Mekia Truclaye Kauffman | Surgery | 1934 Alcoa Hwy Ste D-362, Knoxville, TN 37920-1524 | 2018-04-04 |
1497137574 | Daniel A Hatef Md, Pllc | Surgery | 6200 Highway 100 Ste 101, Nashville, TN 37205-4252 | 2015-06-24 |
1336588201 | Nashville Plastic and Reconstructive Surgery, Plc | Surgery | 2201 Murphy Ave Ste 301, Nashville, TN 37203-1956 | 2013-06-24 |
1851657597 | Jordi Puente Espel | Surgery | 6215 Humphreys Blvd Ste 103, Memphis, TN 38120-2382 | 2012-04-06 |
1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
1942500319 | Sieveking Plastic Surgery | Surgery | 204 23rd Ave N, Nashville, TN 37203-1502 | 2010-11-01 |
1275733081 | Natasha Nicole Luckey | Surgery | 2001 Mallory Ln Ste 205, Franklin, TN 37067-8235 | 2007-07-19 |
1841406063 | Robert F Garza | Surgery | 4322 Harding Rd, Suite 326, Nashville, TN 37205-2490 | 2007-05-15 |
1558583021 | Stewart Charles Little | Surgery | 2358 Lifestyle Way Ste 212, Chattanooga, TN 37421-2291 | 2007-05-03 |
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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.