Mountain Region Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOUNTAIN REGION FAMILY MEDICINE, PC

Practice address

101 Professional Park PVT Dr
Kingsport, TN 37663-2288

Phone

(423) 230-7300

NPI assigned

Mar 13, 2020

Organization subpart

No

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

Authorized official

Name

Wanda Trent

Title

Corporate Secretary

Phone

(423) 230-2109

Specialties & licenses 1

Addresses

Other names 1

• MRFM Colonial Hts - Weekend Clinic Doing business as

Locations

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1659907327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK PVT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632288",
            "telephone_number": "423-230-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN REGION FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "TRENT",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "423-230-2109"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRFM Colonial Hts - Weekend Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael B Morris
• Sara Morris
• Troy Moss
• Whittaker Moss, DDS
• Mountain Empire Medical Transportation, LLC
• Mountain Region Family Medicine, PC
• Mountain Region Family Medicine, PC
• Mountain Region Speech and Hearing Center
• Mountain States Health Alliance
• Mountain States Health Alliance

• 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 Mar 13, 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.