Individual provider Active NPI

Diana Nunley, M.D.

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1215922133
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD17417 Issued in TN
Practice address
4 Sheridan SQ
Suite 200
Kingsport, TN 37660-7390
Phone
(423) 246-7931
Fax
(423) 246-1906
NPI assigned
Sep 16, 2005
Last updated
Oct 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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 MD17417 TN Primary

Addresses

Primary practice location

4 Sheridan SQ
Suite 200
Kingsport, TN 37660-7390

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 246-7931

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
I20080604000705 TN Practitioner - Internal Medicine 4880764612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD17417TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Internal Medicine CurrentSince Jun 15, 2008 Accepting new patients
Medical Education Assistance Corporation Internal Medicine Past Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

146 W Park Dr
Ste 9G
Kingsport, TN 37660
Phone (423) 246-7931

4 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 246-7931

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1215922133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-246-7931",
            "fax_number": "423-246-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-246-7931",
            "fax_number": "423-246-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNLEY",
        "first_name": "DIANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD17417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.