Jennifer Carlita Peters-Diamond, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

48169 Issued in TN

Practice address

111 W Stone Dr
Suite 110
Kingsport, TN 37660-6027

Phone

(423) 723-2030

Fax

(423) 247-4110

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer Peters Professional name

Medicare fee-for-service enrollment

Enrolled in VA, TN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257

  Family Medicine

  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Bluefield, VA
  • NPI 1215219878

  Family Medicine

  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1558812198
  NPD
• Medexpress Urgent Care, PC - Virginia

  • Urgent Care Clinic/Center
  • Richmond, VA
  • NPI 1225563679

  Family Medicine

  NPD
• St Charles Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Haysi, VA
  • NPI 1952423667
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1578640561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR",
            "address_2": "SUITE 110",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-723-2030",
            "fax_number": "423-247-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS-DIAMOND",
        "first_name": "JENNIFER",
        "middle_name": "CARLITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101240169",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "48169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007604092",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PETERS",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christopher A Pendola, M.D.
• Skylar Dane Pentasuglia, AUD
• Katie E Perdue
• Kiley Morgan Perethian, D.O.
• Benjamin James Perrault, DMD
• Mary Louise Peters
• Shae Peters
• Heather Phelps, NP-C
• Phillip Marshall DDS PC
• Courtney Lynn Phillips-Brown, PHARMD/MPH

• Family Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.

Verify at the official NPI Registry.