Tri-Cities Endoscopy Center PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TRI-CITIES ENDOSCOPY CENTER PC

Doing business as

The Center for Digestive Wellness

Practice address

10461 Wallace Alley St
Kingsport, TN 37663-3936

Phone

(423) 279-1400

NPI assigned

Jul 13, 2006

Last updated

Oct 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Carmela Merritt

Title

Practice Administrator

Phone

(423) 279-1414

Specialties & licenses 2

Addresses

Other names 1

• The Center for Digestive Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Tricities Endoscopy Center PCCCN 44C0001122

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Stephen W Fry, M.D.

  • Gastroenterology Physician
  • Kingsport, TN
  • NPI 1750382982
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1063437994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES ENDOSCOPY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "CARMELA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "423-279-1414"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "TN",
            "license": "151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Digestive Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tri City Radiology Group, PC
• Tri City Transport, LLC (Tri City Transport)
• Tri Star Strength X Rehab
• Tri-Cities Acupuncture and Wellness LLC.
• Tri-Cities Center for Christian Counseling
• Tri-Cities Gastroenterology LLC
• Tri-Cities Pediatric Therapy, LLC
• Tri-Star Counseling, LLC
• Tricare Behavorial Health LLC (Stress Care Associates)
• Tricare Behavorial Health, LLC Group

• Ambulatory Surgical Clinic/Center in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.