Cynthia Poortenga, MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD0000017131 Issued in TN

Legal business name

CYNTHIA POORTENGA, MD PC

Doing business as

Cynthia Poortenga, MD PC

Practice address

121 E Ravine Rd
Ste 900
Kingsport, TN 37660-3816

Phone

(423) 230-4800

Fax

(423) 230-4808

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia L Poortenga, M.D.

Title

President

Phone

(423) 230-4800

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Cynthia Poortenga, MD PC Doing business as

Locations

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1922171149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E RAVINE RD",
            "address_2": "STE 900",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603816",
            "telephone_number": "423-230-4800",
            "fax_number": "423-230-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E RAVINE RD",
            "address_2": "STE 900",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603816",
            "telephone_number": "423-230-4800",
            "fax_number": "423-230-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYNTHIA POORTENGA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "POORTENGA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-230-4800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "MD0000017131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3372564",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5645956",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS VA",
            "identifier": "246269",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4054392",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cynthia Poortenga, MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Howard Lee Cummings, M.D.
• Scott Matthew Cureton, DDS
• Steven Lee Cureton, DMD MS
• Lauren Ernst Curry, APRN, FNP-C
• Custom Orthotics & Prosthetics
• Joann W. D'Aprile-Lubrano, D.O.
• Joan Colette D'Cruz, APRN, BC
• Amirah Hasan Daher, MD
• Kayla Marie Dahley, D.O.
• Danielle Dahlin, RD

• Primary Care Clinic/Center in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.