KINGSPORT ENDOSCOPY CORPORATION NPI 1578558078

NPI Information

NPI: 1578558078
Provider Name: KINGSPORT ENDOSCOPY CORPORATION
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
135 W RAVINE RD
SUITE 7A
KINGSPORT, TN
ZIP 37660
Phone: (423) 246-6777
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KINGSPORT ENDOSCOPY CORPORATION is an ambulatory surgical clinic center in Kingsport, TN. KINGSPORT ENDOSCOPY CORPORATION NPI is 1578558078. The provider is registered as an organization entity type.

The provider's business location address is:

135 W RAVINE RD
SUITE 7A
KINGSPORT, TN
ZIP 37660-847
Phone: (423) 246-6777
Fax: (423) 246-7766

The provider's authorized official is Mark Bartley .
The authorized official title is Chief Administrative Officer and has the following contact phone number (423) 246-6777.

The enumeration date for this NPI number is 9/12/2005 and was last updated on 5/4/2009.

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	0000000055	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	3287295	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE
2	000815	OTHER	VIRGINIA	ANTHEM
3	36000412	MEDICAID	KENTUCKY
4	100020225	OTHER	TENNESSEE	PHP TENNCARE
5	3287295	MEDICAID	TENNESSEE
6	001000993	OTHER	TENNESSEE	BCBS OF TN
7	490001203	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE	RAILROAD
8	007641354	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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