CLINCHFIELD FAMILY MEDICINE PLLC NPI 1316228075

NPI Information

NPI: 1316228075
Provider Name: CLINCHFIELD FAMILY MEDICINE, PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 44D2030457

Address:
2204 PAVILION DR
SUITE 110
KINGSPORT, TN
ZIP 37660
Phone: (423) 378-1500
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CLINCHFIELD FAMILY MEDICINE, PLLC is a primary care clinic center in Kingsport, TN. CLINCHFIELD FAMILY MEDICINE, PLLC NPI is 1316228075. The provider is registered as an organization entity type.

The provider's business location address is:

2204 PAVILION DR
SUITE 110
KINGSPORT, TN
ZIP 37660-657
Phone: (423) 378-1500
Fax: (423) 378-1520

The provider's authorized official is Holly Charlene Grigsby .
The authorized official title is Owner/medical Director and has the following contact phone number (423) 378-1500.

The CLIA number assigned to this NPI record is 44D2030457 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2011 and was last updated on 10/28/2013.

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	261QP2300X	Clinic/Center	Primary Care	0000042820	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
1	1527171	MEDICAID	TENNESSEE
2	103G701399	MEDICARE PIN	TENNESSEE
3	1316228075	MEDICAID	VIRGINIA

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

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