NPIMap

Organization Active NPI

Associated Orthopaedics of Kingsport PC

  • Orthopaedic Surgery Physician
  • Kingsport, TN
National Provider Identifier
1053683227
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ASSOCIATED ORTHOPAEDICS OF KINGSPORT PC
Practice address
2202 N John B Dennis Hwy
Suite 100
Kingsport, TN 37660-5904
Phone
(423) 245-3161
Fax
(423) 857-8129
NPI assigned
Feb 3, 2012
Last updated
May 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Authorized official

Name
Mrs. Sandra Wells
Title
Practice Manager
Phone
(423) 230-3870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X TN Primary

Addresses

Primary practice location

2202 N John B Dennis Hwy
Suite 100
Kingsport, TN 37660-5904

Mailing address

2202 N John B Dennis Hwy
Suite 100
Kingsport, TN 37660-5904
Phone (423) 245-3161

Other identifiers 1

IdentifierTypeStateIssuer
1528251MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120508000434 TN Part B Supplier - Clinic/Group Practice 4789846700 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Kingsport, TN
O20120517000484 TN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4789846700 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kingsport, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495670400000",
    "number": "1053683227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N JOHN B DENNIS HWY",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605904",
            "telephone_number": "423-245-3161",
            "fax_number": "423-857-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N JOHN B DENNIS HWY",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605904",
            "telephone_number": "423-245-3161",
            "fax_number": "423-857-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED ORTHOPAEDICS OF KINGSPORT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2017-05-25",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "423-230-3870",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528251",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.