ENDOSCOPY CENTER OF KINGSPORT NPI 1235140385

NPI Information

NPI: 1235140385
Provider Name: ENDOSCOPY CENTER OF KINGSPORT

Doing Business As: SULLIVAN DIGESTIVE CENTER

Classification: Clinic/Center - 261QE0800X
Entity Type: Organization

Specialization: Endoscopy

Address:
2204 PAVILION DR STE 108
KINGSPORT, TN
ZIP 37660
Phone: (423) 392-6100
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ENDOSCOPY CENTER OF KINGSPORT is an endoscopy clinic center in Kingsport, TN. ENDOSCOPY CENTER OF KINGSPORT NPI is 1235140385. The provider is registered as an organization entity type.
The provider Is Doing Business As Sullivan Digestive Center.

The provider's business location address is:

2204 PAVILION DR STE 108
KINGSPORT, TN
ZIP 37660-651
Phone: (423) 392-6100
Fax: (423) 392-6159

The provider's authorized official is Penny Leigh Lloyd .
The authorized official title is Administrator and has the following contact phone number (423) 392-6100.

The CLIA number assigned to this NPI record is 44D0885934 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 11/5/2021.

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	261QE0800X	Clinic/Center	Endoscopy	0000000053	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	3287396	MEDICAID	TENNESSEE
2	1000910	OTHER	TENNESSEE	BLUE CROSS BLUE SHIELD

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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