Individual provider Active NPI

Kiran Patibandla, MD

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1184688590
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40033 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3810
Phone
(423) 224-4698
Fax
(423) 224-4693
NPI assigned
Apr 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 40033 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3810

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000321 TN Practitioner - Internal Medicine 9436181195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of Tennessee PCGroup PAC ID 9234432881, 157 clinicians

Practice addresses (Care Compare)

550 Fort Loudon Medical Ctr Dr
Lenoir City, TN 37772-5673
Phone (865) 271-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Kingsport Consultants Internal Medicine Past Accepting new patients
Methodist Medical Center Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

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 4

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184688590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-224-3250",
            "fax_number": "423-224-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603810",
            "telephone_number": "423-224-4698",
            "fax_number": "423-224-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIBANDLA",
        "first_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "40033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.