Organization Active NPI

Kingsport Anesthesia, PLC

  • Specialist
  • Johnson City, TN
National Provider Identifier
1609988930
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD0000034445 Issued in TN
Legal business name
KINGSPORT ANESTHESIA, PLC
Practice address
302 Wesley St Ste 3
Johnson City, TN 37601-1741
Phone
(423) 283-7302
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lorna K Ehrenfried, M.D.
Title
Owner
Phone
(423) 854-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD0000034445 TN Primary

Addresses

Primary practice location

302 Wesley St Ste 3
Johnson City, TN 37601-1741

Mailing address

3101 Browns Mill Rd Ste 6 PMB 386
Johnson City, TN 37604-4100
Phone (423) 854-0001

Other identifiers 2

IdentifierTypeStateIssuer
3856308MedicaidTN
4067843OtherTNBCBS TN PROVIDER NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609988930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROWNS MILL RD STE 6 PMB 386",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044100",
            "telephone_number": "423-854-0001",
            "fax_number": "423-854-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 WESLEY ST STE 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011741",
            "telephone_number": "423-283-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSPORT ANESTHESIA, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EHRENFRIED",
        "authorized_official_first_name": "LORNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-854-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000034445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3856308",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN PROVIDER NUMBER",
            "identifier": "4067843",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.