KINGSPORT AMBULATORY SURGERY CTR NPI 1053404574

NPI Information

NPI: 1053404574
Provider Name: KINGSPORT AMBULATORY SURGERY CTR

Doing Business As: KINGSPORT DAY SURGERY

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2204 PAVILION DRIVE
SUITE 300
KINGSPORT, TN
ZIP 37660
Phone: (423) 857-6300
Get Directions

KINGSPORT AMBULATORY SURGERY CTR is an ambulatory surgical clinic center in Kingsport, TN. KINGSPORT AMBULATORY SURGERY CTR NPI is 1053404574. The provider is registered as an organization entity type.
The provider Is Doing Business As Kingsport Day Surgery.

The provider's business location address is:

2204 PAVILION DRIVE
SUITE 300
KINGSPORT, TN
ZIP 37660-653
Phone: (423) 857-6300
Fax: (423) 857-6324

The provider's authorized official is Jenetha D Moran .
The authorized official title is Officer/authorized Official and has the following contact phone number (972) 763-3893.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 1/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	0000000113	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3288120	MEDICAID	TENNESSEE
2	007603177	MEDICAID	VIRGINIA
3	100032523	OTHER		PHP
4	170411602	MEDICAID	TEXAS
5	227545	OTHER		ANTHEM
6	091618800	MEDICAID	FLORIDA
7	3148953	OTHER		BLUE CROSS
8	36001311	MEDICAID	KENTUCKY
9	7254600	OTHER		CIGNA
10	A3766000	OTHER		JOHN DEERE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »