Kingsport TN Ophthalmology ASC LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

KINGSPORT TN OPHTHALMOLOGY ASC LLC

Practice address

999 Executive Park Blvd
Suite 100
Kingsport, TN 37660-4632

Phone

(423) 247-2022

Fax

(423) 247-2027

NPI assigned

Jun 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• Regional Eye Surgery Center Doing business as

Practitioners 1

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

• Cindy Jewett, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
  • NPI 1619926284

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1497951826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "423-247-2022",
            "fax_number": "423-247-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-247-2022",
            "fax_number": "423-247-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSPORT TN OPHTHALMOLOGY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Eye Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kingsport Primary Care, PC
• Kingsport Primary Healthcare, LLC
• Kingsport Psychiatric Services
• Kingsport Psychiatry & Counseling Services, PLLC
• Kingsport Senior House, LLC
• Kingsport TN Ophthalmology ASC LLC
• Kingsport Urology Group
• Phillip D. Kirby, D.D.S.
• Kevin P Kirk, MD
• Richard B Kirk, MSW LCSW

• Certified Registered Nurse Anesthetist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.