Individual provider Active NPI

Sarah S Youssef

  • Pediatrics Physician
  • Kingsport, TN
National Provider Identifier
1346484862
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD53495 Issued in TN
Practice address
105 W Stone Dr Ste 2a
Kingsport, TN 37660
Phone
(423) 230-2430
Fax
(423) 378-5940
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35-099511 OH
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD53495 TN Primary

Addresses

Primary practice location

105 W Stone Dr Ste 2a
Kingsport, TN 37660

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2093

Other practice location 1

6707 Powers Blvd Ste 203
Parma, OH 44129-5464
Phone (440) 845-1500

Other practice location 2

6707 Powers Blvd Ste 203
Parma, OH 44129-5464
Phone (440) 845-1500

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308001868 TN Practitioner - Pediatric Medicine 6204132814 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-099511OHMDPediatrics Physician
MD53495TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC Pediatrics CurrentSince Mar 4, 2016 Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

2204 Pavilion Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3900

105 W Stone Dr
Ste 2A
Kingsport, TN 37660
Phone (423) 224-3375

Interoperability endpoints

  • Direct secure messaging: sarahyoussef@hmgpath.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1346484862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2093",
            "fax_number": "423-390-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 2A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-230-2430",
            "fax_number": "423-378-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6707 Powers Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "441295464",
            "country_code": "US",
            "telephone_number": "440-845-1500",
            "fax_number": "440-845-9227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6707 Powers Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Parma",
            "state": "OH",
            "postal_code": "441295464",
            "country_code": "US",
            "telephone_number": "440-845-1500",
            "fax_number": "440-845-9227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUSSEF",
        "first_name": "SARAH",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-099511",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD53495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.