Active NPI
Kingsport Anesthesia, PLC
- Specialist
- Johnson City, TN
National Provider Identifier
1609988930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD0000034445
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3856308 | Medicaid | TN | |
| 4067843 | Other | TN | BCBS TN PROVIDER NUMBER |
National Provider Directory
National Provider DirectoryNPI 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.