Provider Type Icon

STATUS ALLERGY CLINIC OF KINGSPORT NPI 1972811503


NPI Information

NPI: 1972811503
Provider Name: STATUS ALLERGY CLINIC OF KINGSPORT
Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization
Address:
1516 BRIDGEWATER DR.
KINGSPORT, TN
ZIP 37660
Phone: (423) 247-1122
Get Directions

STATUS ALLERGY CLINIC OF KINGSPORT is an allergy immunology in Kingsport, TN. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. STATUS ALLERGY CLINIC OF KINGSPORT NPI is 1972811503. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1516 BRIDGEWATER DR.
KINGSPORT, TN
ZIP 37660
Phone: (423) 247-1122
Fax: (423) 247-3856

The provider's authorized official is Nalinchandra Gopaldas Shah .
The authorized official title is President - Md and has the following contact phone number (423) 247-1122.

The enumeration date for this NPI number is 9/16/2010 and was last updated on 9/16/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ZP0102XPathologyAnatomic Pathology & Clinical PathologyMD0000015776TENNESSEENo
2207K00000XAllergy & ImmunologyMD0000015776TENNESSEEYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13079726MEDICARE PINTENNESSEE
2B59718MEDICARE UPINTENNESSEE
364663172MEDICAIDKENTUCKY

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: 4/28/2024

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.