NPIMap

Organization Active NPI

Mountain Region Speech and Hearing Center

  • Speech-Language Pathologist
  • Kingsport, TN
National Provider Identifier
1861427783
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MOUNTAIN REGION SPEECH AND HEARING CENTER
Practice address
301 Louis Street
Suite 101
Kingsport, TN 37660-5195
Phone
(423) 246-4600
Fax
(423) 246-3311
NPI assigned
Jul 11, 2006
Last updated
Jan 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Authorized official

Name
Mrs. Mavis L. Spivey
Title
Director of Administration
Phone
(423) 246-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

301 Louis Street
Suite 101
Kingsport, TN 37660-5195

Mailing address

301 Louis Street
Suite 101
Kingsport, TN 37660-5195
Phone (423) 246-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050928001528 TN Part B Supplier - Clinic/Group Practice 8628003589 Receives reassigned benefits from 2 practitioners
Practice locations: Kingsport, TN
O20110119001369 TN Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 8628003589 Practice locations: Kingsport, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861427783. Details of each certification follow.

  • CCN 446506 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 446506

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MOUNTAIN REGION SPEECH & HEARING CENTER
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 12, 1979
Last certification
Jul 27, 2023
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
301 Louis Street Suite 101
Kingsport, TN 37660

National Provider Directory

National Provider Directory

Locations

301 Louis St
Ste 101
Kingsport, TN 37660
Phone (423) 246-4600

404 Revere St
Kingsport, TN 37660
Phone (423) 246-4600

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1861427783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LOUIS STREET",
            "address_2": "SUITE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605195",
            "telephone_number": "423-246-4600",
            "fax_number": "423-246-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LOUIS STREET",
            "address_2": "SUITE 101",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376605195",
            "telephone_number": "423-246-4600",
            "fax_number": "423-246-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN REGION SPEECH AND HEARING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "SPIVEY",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "423-246-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.