NPIMap

Individual provider Active NPI

Kim Zahnke, M.D.

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1033157284
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD39378 Issued in TN
Practice address
2000 Brookside Dr
Third Floor
Kingsport, TN 37660-4627
Phone
(423) 857-5907
Fax
(423) 857-5904
NPI assigned
Jun 2, 2006
Last updated
Feb 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD39378 TN Primary

Addresses

Primary practice location

2000 Brookside Dr
Third Floor
Kingsport, TN 37660-4627

Mailing address

2000 Brookside Dr
Third Floor
Kingsport, TN 37660-4627
Phone (423) 857-5907

Other identifiers 3

IdentifierTypeStateIssuer
1033157284MedicaidVA
3333285MedicaidTN
3333284MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050826000675 TN Practitioner - HospitalistPractitioner - Internal Medicine 5092746255 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Pepper Branch Physician Services PCGroup PAC ID 4385006758, 25 clinicians
Apogee Medical Group Tennessee PCGroup PAC ID 4688721863, 24 clinicians

Practice addresses (Care Compare)

1559 Sparta St
McMinnville, TN 37110-1316
Phone (931) 815-4000

185 Hospital Rd
Winchester, TN 37398-2404
Phone (931) 967-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39378TNMDPharmacist
MD39378TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince Apr 1, 2013 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Apr 1, 2013 Accepting new patients
Apogee Medical Group Tennessee PC Internal Medicine CurrentSince Oct 11, 2016 Accepting new patients
Southern Tennessee Medical Center LLC Past Accepting new patients

Locations

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

185 Hospital Rd
Winchester, TN 37398
Phone (931) 962-4061

186 Hospital Rd
Ste 200
Winchester, TN 37398
Phone (931) 962-9035

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1033157284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 BROOKSIDE DR",
            "address_2": "THIRD FLOOR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604627",
            "telephone_number": "423-857-5907",
            "fax_number": "423-857-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BROOKSIDE DR",
            "address_2": "THIRD FLOOR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604627",
            "telephone_number": "423-857-5907",
            "fax_number": "423-857-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAHNKE",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD39378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033157284",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3333285",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3333284",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.