NPIMap

Organization Active NPI

Tennessee Cancer Specialist PLLC

  • Hematology & Oncology Physician
  • Kingsport, TN
National Provider Identifier
1659112662
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
TENNESSEE CANCER SPECIALIST PLLC
Practice address
4 Sheridan SQ Ste 102
Kingsport, TN 37660-7435
Phone
(423) 588-7140
Fax
(423) 588-7141
NPI assigned
Jun 4, 2024
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Patricia G Jenkins
Title
Credentialing Coordinator
Phone
(865) 862-0998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

4 Sheridan SQ Ste 102
Kingsport, TN 37660-7435

Mailing address

6016 Brookvale LN Ste 200
Knoxville, TN 37919-4092
Phone (865) 862-0998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702000160 TN Part B Supplier - Clinic/Group Practice 1658358171 Receives reassigned benefits from 69 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson City, TN; Sweetwater, TN; Powell, TN; Oak Ridge, TN; Newport, TN; La Follette, TN; Knoxville, TN; Athens, TN…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Tennessee Cancer Specialist PLLC66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1659112662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 BROOKVALE LN STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194092",
            "telephone_number": "865-862-0998",
            "fax_number": "865-544-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN SQ STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607435",
            "telephone_number": "423-588-7140",
            "fax_number": "423-588-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CANCER SPECIALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "865-862-0998"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "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 Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.