CUMBERLAND BACK PAIN CLINIC (NPI# 1932310828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932310828 |
| Entity Type | Organization |
| Organization Name | CUMBERLAND BACK PAIN CLINIC |
| Other Organization Name | THE PAIN CENTER OF KINGSPORT |
| Practice Address |
1732 N Eastman Rd Kingsport TN 37664-2376 |
| Practice Telephone | 6155912754 |
| Practice Fax Number | 6155912755 |
| Mailing Telephone | 6155912754 |
| Mailing Fax Number | 6155912755 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ANNETTE M DREIFKE (BILLING MANAGER) |
| Authorized Official Telephone | 6155912754 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA918 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| The Pain Center of Kingsport | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871791335 | Cumberland Back Pain Clinic | Nurse Practitioner | 120 Chadwick Square Ct Ste A, Hendersonville, NC 28739-3200 | 2007-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Cumberland Back Pain Clinic P.C. | 725 Cool Springs Blvd., Ste 550, Franklin, Tennessee 37067 |
| Street Address |
1732 N EASTMAN RD |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664-2376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992118814 | Muse Family Chiropractic LLC | Chiropractor | 1732 N Eastman Rd, Suite 3a, Kingsport, TN 37664-2376 | 2014-06-09 |
| 1639486574 | Joseph Allan Muse | Chiropractor | 1732 N Eastman Rd, Suite 3a, Kingsport, TN 37664-2376 | 2010-09-13 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| 1386041101 | Dustin L Barrett | Physician Assistant | 2050 Meadowwview Pkwy., Kingsport, TN 37660-7475 | 2014-11-21 |
| 1265603914 | Stephen Timothy Lawson | Physician Assistant | 121 E Ravine Rd Ste 200, Kingsport, TN 37660-3826 | 2008-03-20 |
| 1477751238 | Clay Deneeen Davis | Physician Assistant | 4509 W Stone Dr, Kingsport, TN 37660-1048 | 2007-07-03 |
| 1568567535 | William Kendall Johnson | Physician Assistant | 3 Sheridan Square, Kingsport, TN 37660 | 2006-09-14 |
| 1306941372 | Clark Rafael Hernandez | Physician Assistant | Three Sheridan Square, Kingsport, TN 37660 | 2006-09-14 |
| 1598364903 | Kevin White | Physician Assistant | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-10-19 |
| 1770195273 | Daulton Horne | Physician Assistant | 105 W Stone Dr Ste 4b, Kingsport, TN 37660-3365 | 2020-08-18 |
| 1245855501 | Carley Neil Carter | Physician Assistant | 105 W Stone Dr Ste 4b, Kingsport, TN 37660-3365 | 2020-06-12 |
| 1982228847 | Jordan Bacon | Physician Assistant | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2020-06-05 |
| 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.