Active NPI
Jeffrey R Kappa, MD
- Surgery Physician
- Kingsport, TN
National Provider Identifier
1285665968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD19361
- Practice address
- 2050 Meadowview Pkwy
Kingsport, TN 37660 - Phone
- (423) 230-5000
- Fax
- (423) 245-2396
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD19361 | TN | Primary |
| Vascular Surgery Physician | 2086S0129X | MD19361 | TN | |
| Colon & Rectal Surgery Physician | 208C00000X | MD19361 | TN |
Addresses
Primary practice location
2050 Meadowview Pkwy
Kingsport, TN 37660
Mailing address
105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0092361 | Other | TN | BCBS TENNESSEE |
| 5208034 | Other | AETNA | |
| 007300280 | Medicaid | VA | |
| 059071 | Other | VA | ANTHEM BCBS VIRGINIA |
| 3045415 | Medicaid | TN | |
| 20009693 | Other | TN | RAILROAD MEDICARE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19361 | TN | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Surgery | Current | Accepting new patients |
| Wellmont Medical Associates, Inc. | Past | Accepting new patients |
Locations
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
444 Clinchfield St
Ste 2900
Kingsport, TN 37660
Phone (423) 245-6101
105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1285665968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W STONE DR",
"address_2": "SUITE 6A",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603365",
"telephone_number": "423-408-7220",
"fax_number": "423-408-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 MEADOWVIEW PKWY",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37660",
"telephone_number": "423-230-5000",
"fax_number": "423-245-2396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAPPA",
"first_name": "JEFFREY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "MD19361",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "TN",
"license": "MD19361",
"primary": false
},
{
"code": "208C00000X",
"taxonomy_group": "",
"desc": "Colon & Rectal Surgery",
"state": "TN",
"license": "MD19361",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TENNESSEE",
"identifier": "0092361",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5208034",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007300280",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS VIRGINIA",
"identifier": "059071",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3045415",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "20009693",
"state": "TN"
}
],
"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 Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.