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Wellmont Physician Services Inc

Organization Active NPI Internal Medicine Physician · Kingsport, TN

NPI 1285680819 · NPPES record last updated Sep 16, 2010

Key facts

NPI
1285680819
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
WELLMONT PHYSICIAN SERVICES INC
Practice address
999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone
(423) 224-3250
Fax
(423) 224-3258
NPI assigned
May 25, 2006
Organization subpart
No

Authorized official

Name
Mrs. Cindy Locke, CPC, CCS-P
Title
Billing Administrator
Phone
(423) 224-3289

Corporate family (same tax ID) 15

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Wellmont Physician Services Inc (16 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207L00000X
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207R00000X Yes
Hematology & Oncology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207RH0003X
Infectious Disease Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207RI0200X
Obstetrics & Gynecology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207V00000X
Maternal & Fetal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207VM0101X
Orthopaedic Surgery Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207X00000X
Pediatrics Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 208000000X
Medical Physician Assistant
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363AM0700X
Surgical Physician Assistant
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363AS0400X
Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363L00000X
Pediatric Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363LP0200X
Obstetrics & Gynecology Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363LX0001X
Certified Registered Nurse Anesthetist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 367500000X

Addresses

Primary practice location

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1527279OtherTNUMWA
3709584MedicaidTN
65931099MedicaidKY
23305008OtherTNFEDERAL BLACK LUNG

Other providers in Kingsport, TN

All providers in Kingsport, TN · Internal Medicine Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.