NPIMap

Organization Active NPI

Kingsport Bronchoscopy Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Kingsport, TN
National Provider Identifier
1306898416
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0000000054 Issued in TN
Legal business name
KINGSPORT BRONCHOSCOPY CENTER, INC.
Practice address
111 W Stone Dr
Suite 100
Kingsport, TN 37660-6027
Phone
(423) 247-5197
Fax
(423) 247-5254
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Shirley Hawkins
Title
Administrator
Phone
(423) 247-5197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0000000054 TN Primary

Addresses

Primary practice location

111 W Stone Dr
Suite 100
Kingsport, TN 37660-6027

Mailing address

111 W Stone Dr
Suite 100
Kingsport, TN 37660-6027
Phone (423) 247-5197

Other identifiers 2

IdentifierTypeStateIssuer
1000908OtherTNBLUE CROSS BLUE SHIELD
3287305MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1306898416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W STONE DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSPORT BRONCHOSCOPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-247-5197"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1000908",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287305",
            "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 Feb 28, 2008; 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.