David J Kickliter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17859 Issued in TN

Practice address

407 4TH St
Newport, TN 37821-3755

Phone

(423) 623-6240

Fax

(423) 623-0102

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1609850569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 4TH ST",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213755",
            "telephone_number": "423-623-6240",
            "fax_number": "423-623-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 4TH ST",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378213755",
            "telephone_number": "423-623-6240",
            "fax_number": "423-623-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLITER",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "17859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3028740",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arvo Kanna, M.D.
• Sukhender Kumar Karwan, MD
• Nicholas Kaye
• Lawrence Avery Kennard, FNP
• Kenneth Hill, PLLC
• Justin Kickliter, PHARM.D.
• Kidz Zone
• Patricia Kinsler, LPN
• Kesley Kirk, PT, DPT
• Catrina Knight

• Family Medicine Physician in Newport, TN
• Providers in Newport, 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 Nov 6, 2013; 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.