Manal Ahmad, M.D.
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Kingsport, TN
NPI 1366068975 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1366068975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 74257 (TN)
- Practice address
- 2204 Pavilion Dr Ste 310
Kingsport, TN 37660-4653 - Phone
- (423) 224-3900
- NPI assigned
- Jun 19, 2020
- Reactivated
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellmont Medical Associates Inc
Practice addresses (Care Compare)
2204 Pavilion Dr
Suite 310
Kingsport, TN 37660-4653
Phone (423) 246-4155
Hospital & facility affiliations
- Johnson City Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260408002003 | TN | Practitioner - Endocrinology | 1658738273 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74257 | TN | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 74257 | TN | Yes |
Addresses
Primary practice location
2204 Pavilion Dr Ste 310
Kingsport, TN 37660-4653
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111
Other providers in Kingsport, TN
- Advanced Therapy of Kingsport
- Agilitas USA, Inc
- Agilitas USA, Inc
- Agilitas USA, Inc.
- Abrar Ahmad
- Summer Ahmed
- Ahp of East Tennessee PLLC
- Robert Bryce Ailshie
- Chaz M Ainsworth
- Megan Teresa Akins
All providers in Kingsport, TN · Endocrinology, Diabetes & Metabolism Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.