Individual provider Active NPI

Brian Elliott Himelwright, DDS

  • Dentist
  • Kingsport, TN
National Provider Identifier
1548332679
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS6932 Issued in TN
Practice address
8 Sheridan SQ Ste 100
Kingsport, TN 37660-7479
Phone
(423) 247-7731
Fax
(423) 247-7706
NPI assigned
Nov 14, 2006
Last updated
Dec 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS6932 TN Primary

Addresses

Primary practice location

8 Sheridan SQ Ste 100
Kingsport, TN 37660-7479

Mailing address

8 Sheridan SQ Ste 100
Kingsport, TN 37660-7479
Phone (423) 247-7731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS6932TNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1548332679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SHERIDAN SQ STE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607479",
            "telephone_number": "423-247-7731",
            "fax_number": "423-247-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SHERIDAN SQ STE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607479",
            "telephone_number": "423-247-7731",
            "fax_number": "423-247-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMELWRIGHT",
        "first_name": "BRIAN",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS6932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.