Active NPI
Ke Qi, DDS
- Dentist
- Kingsport, TN
National Provider Identifier
1518309657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9696
- Practice address
- 116 Jack White Dr
Suite 12
Kingsport, TN 37664-2380 - Phone
- (423) 247-6961
- Fax
- (423) 247-5552
- NPI assigned
- Jul 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9696 | TN | Primary |
Addresses
Primary practice location
116 Jack White Dr
Suite 12
Kingsport, TN 37664-2380
Mailing address
116 Jack White Dr
Suite 12
Kingsport, TN 37664
Phone (423) 247-6961
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160427001186 | TN | Order and Referring Only - Dentist | 8022317908 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9696 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dental Center Tricities, PC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Kingsport, TN
- NPI 1588326144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1518309657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 JACK WHITE DR",
"address_2": "SUITE 12",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37664",
"telephone_number": "423-247-6961",
"fax_number": "423-247-5552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 JACK WHITE DR",
"address_2": "SUITE 12",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376642380",
"telephone_number": "423-247-6961",
"fax_number": "423-247-5552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QI",
"first_name": "KE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-17",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "9696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
- Cynthia Norris Pulitzer, D.D.S.
- Samuel Flettrich Pulitzer, D.D.S.
- Venkata Siva Krishna Pulivarthi, MD
- Pulmonary Associates of Kingsport
- Pulmonary Associates of Kingsport (Sleep Evaluation Center)
- Adrian Denise Qualls, PA-C
- James Paul Qualls, DO
- Joseph Donald Qualls
- Linda Qualls, FNP
- Kyle Phillip Radack, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.