Individual provider Active NPI

Taif Khattak, MD

  • Hospitalist Physician
  • Kingsport, TN
National Provider Identifier
1679208078
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
74049 Issued in TN
Practice address
4 Sheridan SQ Ste 200
Kingsport, TN 37660-7435
Phone
(423) 246-7931
NPI assigned
Jul 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 74049 TN Primary
Internal Medicine Physician 207R00000X 74049 TN

Addresses

Primary practice location

4 Sheridan SQ Ste 200
Kingsport, TN 37660-7435

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

325 N State Of Franklin Rd Fl 2
Johnson City, TN 37604-6092
Phone (423) 439-7280

Other identifiers 2

IdentifierTypeStateIssuer
1679208078MedicaidVA
Q076331MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250926002942 TN Practitioner - Internal Medicine 2062917222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Education Assistance CorporationGroup PAC ID 3870491269, 168 clinicians

Practice addresses (Care Compare)

4 Sheridan SQ
Suite 200
Kingsport, TN 37660-7435
Phone (423) 246-7931

Hospital & facility affiliations

  • Ballad Health Homecare Home health agency, Johnson City, TN, CCN 447240
  • Ballad Health Hospice Hospice, Bristol, TN, CCN 441558
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74049TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Medical Education Assistance Corporation Internal Medicine PastSince Sep 1, 2025 Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

325 N State of Franklin Rd
Fl 2
Johnson City, TN 37604
Phone (423) 439-7280

4 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 246-7931

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1679208078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN SQ STE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607435",
            "telephone_number": "423-246-7931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N State Of Franklin Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046092",
            "country_code": "US",
            "telephone_number": "423-439-7280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "TAIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "74049",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "74049",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679208078",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076331",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.