Psychiatric Associates of Kingsport LLP

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD0000020620 Issued in TN

Legal business name

PSYCHIATRIC ASSOCIATES OF KINGSPORT LLP

Practice address

444 Clinchfield St Ste 101
Kingsport, TN 37660-3859

Phone

(423) 392-6500

Fax

(423) 392-6504

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eric D Moffet, M.D.NPI 1609984178

Title

M.D. Partner

Phone

(423) 392-6500

Specialties & licenses 3

Addresses

Other identifiers 9

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric David Moffet, MD

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1609984178
  NPD Authorized official
• Ronald Steven Smith, MD

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1649363425
  NPD (past)
• Kranthi Boyapati, MD

  • Psychiatry Physician
  • Leesburg, FL
  • NPI 1174587687
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1750485322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603859",
            "telephone_number": "423-392-6500",
            "fax_number": "423-392-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD ST STE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603859",
            "telephone_number": "423-392-6500",
            "fax_number": "423-392-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES OF KINGSPORT LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "MOFFET",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "M.D. PARTNER",
        "authorized_official_telephone_number": "423-392-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000016494",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000020620",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000013797",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOFFET BCVA",
            "identifier": "069099",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3189819",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOFFET BCTN",
            "identifier": "0105831",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMITH BCTN",
            "identifier": "0018152",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMITH BCVA",
            "identifier": "069098",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KUTTY BC VA",
            "identifier": "069097",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3052859",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KUTTY BC TN",
            "identifier": "0048066",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016081",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Proffitt
• Katie M Prosser, DO
• Gilgia Prumbs, PT
• Michael Prumbs, LPO
• David Matthew Pryputniewicz, MD
• Psychiatric Care of Kingsport PC
• PT Solutions LLC
• Austin James Puchany, DO
• Alicia Leeann Pugh, FNP-BC
• Jessica Elise Pugh, MD

• Psychiatry Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.