Organization Active NPI

Urology Associates of Kingsport, P. C.

  • Urology Physician
  • Kingsport, TN
National Provider Identifier
1184644932
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY ASSOCIATES OF KINGSPORT, P. C.
Practice address
822 Broad St
Kingsport, TN 37660-3718
Phone
(423) 246-6251
Fax
(423) 246-7230
NPI assigned
Jul 21, 2006
Last updated
Apr 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Dr. Jim R Litttlejohn, M. D.
Title
President
Phone
(423) 246-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X TN Primary

Addresses

Primary practice location

822 Broad St
Kingsport, TN 37660-3718

Mailing address

822 Broad St
Kingsport, TN 37660-3718
Phone (423) 246-6251

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051221001032 TN Part B Supplier - Clinic/Group Practice 7113949801 Receives reassigned benefits from 2 practitioners
Practice locations: Kingsport, TN
O20100930025894 TN DME Supplier - Physician - Urology 7113949801 Practice locations: Kingsport, TN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0311129Urology Associates of Kingsport PC822 Broad St, Kingsport, TN 37660Provider-performed microscopyOct 31, 2027

National Provider Directory

National Provider Directory

Locations

822 Broad St
Kingsport, TN 37660
Phone (423) 246-6251

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1184644932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 BROAD ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603718",
            "telephone_number": "423-246-6251",
            "fax_number": "423-246-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY ASSOCIATES OF KINGSPORT, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "LITTTLEJOHN",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-246-6251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 4, 2017; 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.