Kurt A Ick, MD
Individual provider Active NPI Urology Physician · Kingsport, TN
NPI 1760439152 · NPPES record last updated Mar 15, 2011
Key facts
- NPI
- 1760439152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- MD28950 (TN)
- Practice address
- 1932 Brookside Dr
Kingsport, TN 37660 - Phone
- (423) 246-4155
- Fax
- (423) 246-7169
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Urology
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Suite 80690
Canton, OH 44708
PO Box
Suite 80690
Cannon, OH 44708-0690
Hospital & facility affiliations
- Genesis Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD28950 | TN | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Health System | Current | Accepting new patients | |
| Invigilo Anesthesia Inc | Past | Accepting new patients |
Interoperability endpoints
- kick26259@balladhealth.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD28950 | TN | Yes |
Addresses
Primary practice location
1932 Brookside Dr
Kingsport, TN 37660
Mailing address
1932 Brookside Dr
Kingsport, TN 37660
Phone (423) 246-4155
Other providers in Kingsport, TN
- Colby Hutson
- Jena Elise Hutson
- Savannah Faith Hutson
- Rita Dawn Hutton
- Vickie Hyder
- Id Micro PLLC
- Lilian Imhaze Ikele
- Illuminate Ketamine Center PLLC
- Independent Physical Therapy
- Independent Physical Therapy
All providers in Kingsport, TN · Urology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.