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CYNTHIA POORTENGA MD PC NPI 1922171149


NPI Information

NPI: 1922171149
Provider Name: CYNTHIA POORTENGA, MD PC

Doing Business As: CYNTHIA POORTENGA, MD PC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 44D1008995

Address:
121 E RAVINE RD
STE 900
KINGSPORT, TN
ZIP 37660
Phone: (423) 230-4800
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CYNTHIA POORTENGA, MD PC is a primary care clinic center in Kingsport, TN. CYNTHIA POORTENGA, MD PC NPI is 1922171149. The provider is registered as an organization entity type.
The provider Is Doing Business As Cynthia Poortenga, Md Pc.

The provider's business location address is:

121 E RAVINE RD
STE 900
KINGSPORT, TN
ZIP 37660-816
Phone: (423) 230-4800
Fax: (423) 230-4808

The provider's authorized official is Cynthia L Poortenga .
The authorized official title is President and has the following contact phone number (423) 230-4800.

The CLIA number assigned to this NPI record is 44D1008995 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/16/2006 and was last updated on 4/20/2008.


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
1261QP2300XClinic/CenterPrimary CareMD0000017131TENNESSEEYes

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
15645956MEDICAIDVIRGINIA
2=========01OTHERTENNESSEEJOHN DEERE UHC
3246269OTHERVIRGINIAANTHEM BCBS VA
44054392OTHERTENNESSEEBCBS TN
53372564MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEGROUP
63372564MEDICAIDTENNESSEE
7B58959MEDICARE UPINTENNESSEE
83022833MEDICARE ID-TYPE UNSPECIFIEDTENNESSEEINDV NUMBER

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

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.