Mediserve Medical Equipment of Kingsport, Inc.
Organization Active NPI Durable Medical Equipment & Medical Supplies · Gray, TN
NPI 1962587832 · NPPES record last updated Jul 17, 2025
Key facts
- NPI
- 1962587832
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- MEDISERVE MEDICAL EQUIPMENT OF KINGSPORT, INC.
- Practice address
- 1183 Spratlin Park Dr
Gray, TN 37615-6205 - Phone
- (423) 477-9806
- Fax
- (423) 477-3571
- NPI assigned
- Oct 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Gregory J Crawford
- Title
- President
- Phone
- (859) 300-6455
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 2
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Quipt Home Medical |
Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|Ultraviolet Light Devices and/or Supplies|Canes and/or Crutches|Pat… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930041545 | TN | DME Supplier - Medical Supply Company With Respiratory Therapist |
3678691243 | Practice locations: Gray, TN |
National Provider Directory
- Tax ID family
- Mediserve Med Equip-KSPT
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
1183 Spratlin Park Dr
Gray, TN 37615-6205
Mailing address
1019 Town Dr
Highland Heights, KY 41076-9114
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3547849 | Medicaid | TN |
Other names
- Ballad Health Medical Equipment
Other providers in Gray, TN
- Daniel Lee Marshall
- Elizabeth McFarland
- Leslie Anne Lowe Meade
- Medical Education Assistance Corporation
- Medical Education Assistance Corporation
- Michael a. Wolf
- Nicole M Miller
- Craig Paul Moorhouse
- Sarah Morgan
- Leah Moseley
All providers in Gray, TN · Durable Medical Equipment & Medical Supplies in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.