Individual provider Active NPI

Diana Reinhardt, D.O.

  • Pediatrics Physician
  • Kingsport, TN
National Provider Identifier
1811188436
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO2189 Issued in TN
Practice address
2004 American Way Ste 207
Kingsport, TN 37660-4672
Phone
(423) 392-6700
Fax
(423) 830-7455
NPI assigned
Aug 8, 2007
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 2331 WV
Pediatrics Physician 208000000X DO2189 TN Primary

Addresses

Primary practice location

2004 American Way Ste 207
Kingsport, TN 37660-4672

Mailing address

2004 American Way Ste 207
Kingsport, TN 37660-4672
Phone (423) 392-6700

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
I20101215000850 TN Practitioner - Pediatric Medicine 5395932487 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2189TNMDOptometrist
2189GAMDOptician
2331WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Pediatrics PLLC Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
Mountain States Health Alliance Past Accepting new patients

Locations

2004 American Way
Ste 207
Kingsport, TN 37660
Phone (423) 247-1362

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1811188436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 AMERICAN WAY STE 207",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604672",
            "telephone_number": "423-392-6700",
            "fax_number": "423-830-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 AMERICAN WAY STE 207",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604672",
            "telephone_number": "423-392-6700",
            "fax_number": "423-830-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINHARDT",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "2331",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "DO2189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.