NPIMap

Individual provider Active NPI

Kiley Morgan Perethian, D.O.

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1851852321
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4714 Issued in TN
Practice address
111 W Stone Dr Ste 200
Kingsport, TN 37660-6028
Phone
(423) 723-2030
Fax
(423) 247-4110
NPI assigned
Mar 27, 2019
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4714 TN Primary

Addresses

Primary practice location

111 W Stone Dr Ste 200
Kingsport, TN 37660-6028

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other practice location 2

102 E Ravine Rd
Kingsport, TN 37660-3814
Phone (423) 245-9600

Other names 1

  • Kiley Diane Morgan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kperethian151265@balladhealth.medalliesdirect.net Direct Wellmont Medical Associates Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915001768 TN Practitioner - Family Practice 4880926039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Suite 200
Kingsport, TN 37660-6027
Phone (423) 723-2030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4714TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Wellmont Health System Current Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Wellmont Medical Associates, Inc. Past Accepting new patients
Medical Education Assistance Corporation Family Medicine PastSince Jun 15, 2008 Accepting new patients
Medical Education Assistance Corporation Family Medicine Past Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

115 Judge Gresham Rd
Ste A
Gray, TN 37615
Phone (423) 467-3000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

111 W Stone Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3375

Interoperability endpoints

  • Direct secure messaging: kperethian151265@balladhealth.medalliesdirect.net

Organizations & group practices 7

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.

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1851852321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR STE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606028",
            "telephone_number": "423-723-2030",
            "fax_number": "423-247-4110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Judge Gresham Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376156213",
            "country_code": "US",
            "telephone_number": "423-467-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603814",
            "country_code": "US",
            "telephone_number": "423-245-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERETHIAN",
        "first_name": "KILEY",
        "middle_name": "MORGAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "4714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kperethian151265@balladhealth.medalliesdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Ballad Health Care Everywhere",
            "affiliationName": "Wellmont Medical Associates Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "102 E Ravine Rd",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376603814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KILEY",
            "last_name": "MORGAN",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.