NPIMap

Organization Active NPI

Centerpoint Medical Clinic LLC

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1295778538
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTERPOINT MEDICAL CLINIC LLC
Practice address
2020 Brookside Drive
Suite 20
Kingsport, TN 37660
Phone
(423) 247-7030
Fax
(423) 247-7033
NPI assigned
Jun 14, 2006
Last updated
Sep 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Mrs. Ina K Bone, NPNPI 1962485870
Title
NP/Co-Owner
Phone
(423) 247-7030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TN Primary

Addresses

Primary practice location

2020 Brookside Drive
Suite 20
Kingsport, TN 37660

Mailing address

PO Box 4842
Johnson City, TN 37602-4842
Phone (423) 247-7030

Other identifiers 1

IdentifierTypeStateIssuer
3721007MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1295778538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4842",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376024842",
            "telephone_number": "423-247-7030",
            "fax_number": "423-247-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BROOKSIDE DRIVE",
            "address_2": "SUITE 20",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-247-7030",
            "fax_number": "423-247-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERPOINT MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "BONE",
        "authorized_official_first_name": "INA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "NP/CO-OWNER",
        "authorized_official_telephone_number": "423-247-7030",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721007",
            "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 Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.