Psychiatric Care of Kingsport PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PSYCHIATRIC CARE OF KINGSPORT PC

Doing business as

Psychiatric Care of Kingsport PC

Practice address

444 Clinchfield St Ste 101
Kingsport, TN 37660-3859

Phone

(423) 392-6502

Fax

(423) 392-6504

NPI assigned

Jun 7, 2023

Last updated

Jun 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judy R Wampler

Title

Office Manager

Phone

(423) 392-6502

Specialties & licenses 1

Addresses

Other names 1

• Psychiatric Care of Kingsport PC Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

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.

• Eric David Moffet, MD

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1609984178
  Medicare reassignment NPD
• Ittamveetil Narayanan Kutty, MD

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1609891563
  NPD (past)
• Ronald Steven Smith, MD

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1649363425
  NPD (past)
• Kranthi Boyapati, MD

  • Psychiatry Physician
  • Leesburg, FL
  • NPI 1174587687
  NPD (past)

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1326732793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603859",
            "telephone_number": "423-392-6502",
            "fax_number": "423-392-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603859",
            "telephone_number": "423-392-6502",
            "fax_number": "423-392-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC CARE OF KINGSPORT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "WAMPLER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-392-6502"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Care of Kingsport PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie M Prosser, DO
• Gilgia Prumbs, PT
• Michael Prumbs, LPO
• David Matthew Pryputniewicz, MD
• Psychiatric Associates of Kingsport LLP
• PT Solutions LLC (PT Solutions of VA)
• Austin James Puchany, DO
• Alicia Leeann Pugh, FNP-BC
• Jessica Elise Pugh, MD
• Thomas F. Pugh Jr., M.D.

• Psychiatry Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.