Centennial Physician Services, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CENTENNIAL PHYSICIAN SERVICES, PC

Practice address

130 W Ravine Rd
Kingsport, TN 37660-3831

Phone

(423) 224-4000

NPI assigned

Apr 13, 2026

Last updated

Apr 13, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Heinrich, MD

Title

President/Owner

Phone

(337) 609-1221

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 8

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.

• Michael Eugene Sutherland Jr., D.O.

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1639442213
  Medicare reassignment Care Compare group
• Elli Bonnett Saraceno, M.D.

  • Internal Medicine Physician
  • Asheville, NC
  • NPI 1154697563

  TN

  Medicare reassignment Care Compare group
• Micah Burwell Shook, DO

  • Internal Medicine Physician
  • Hendersonville, NC
  • NPI 1497320956

  TN

  Medicare reassignment Care Compare group
• Isioma Ruth Aninyei, M.D

  • Hospitalist Physician
  • Greeneville, TN
  • NPI 1235450248
  Medicare reassignment
• Sharjeel Iqbal, MD

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1417142159
  Medicare reassignment
• Makram Adel Jurdi, MD

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1124281894
  Medicare reassignment
• Mihir Patel, MD

  • Hospitalist Physician
  • Johnson City, TN
  • NPI 1528226016
  Medicare reassignment
• Adnan Habib, M.D.

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1699088864
  Care Compare group

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

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1871436022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603831",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL PHYSICIAN SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "337-609-1221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa Cassedy
• Kelly J. Cassedy, M.D.
• Kennedy Gambill Caudill, PHARMD
• Cave's Drug Store Inc. (Caves Drug Store)
• CBT Solutions, Inc.
• Centerpoint Medical Clinic LLC
• Centerpointe Medical Clinic, LLC
• Centerwell Certified Healthcare Corp. (CenterWell Home Health)
• Emilee Ann Chacon, BCBA
• Frank B Chadwick Jr., MD

• Internal Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.