NPIMap

Organization Active NPI

Premise Health of Tennessee Medical PC

Doing business as City of Kingsport

  • Multi-Specialty Clinic/Center
  • Kingsport, TN
National Provider Identifier
1215500483
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF TENNESSEE MEDICAL PC
Doing business as
City of Kingsport
Practice address
415 Broad St Ste 644
Kingsport, TN 37660-4207
Phone
(423) 343-9851
Fax
(423) 343-9851
NPI assigned
Jul 23, 2021
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

415 Broad St Ste 644
Kingsport, TN 37660-4207

Mailing address

5500 Maryland Way
Brentwood, TN 37027-7048

Other names 1

  • City of Kingsport Doing business as

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
44D2062360Premise Health of Tennessee Medical, PC415 Broad Street, Suite 644, Kingsport, TN 37660Certificate of waiverJul 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Tennessee Medical PC45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Locations

415 Broad St
Ste 644
Kingsport, TN 37660
Phone (423) 343-9851

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1215500483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROAD ST STE 644",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604207",
            "telephone_number": "423-343-9851",
            "fax_number": "423-343-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF TENNESSEE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Kingsport",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City of Kingsport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.