Organization Active NPI

Primary Care of Kingsport PLLC

  • Family Medicine Physician
  • Kingsport, TN
National Provider Identifier
1972429348
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE OF KINGSPORT PLLC
Practice address
2020 Meadowview Pkwy Ste 200
Kingsport, TN 37660-7388
Phone
(423) 678-1399
Fax
(423) 259-4964
NPI assigned
Jun 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Marissa Vito Cruz, MD
Title
Owner
Phone
(276) 870-1699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2020 Meadowview Pkwy Ste 200
Kingsport, TN 37660-7388

Mailing address

2020 Meadowview Pkwy Ste 200
Kingsport, TN 37660-7388
Phone (423) 678-1399

National Provider Directory

National Provider Directory

Locations

2020 Meadowview Pkwy
Ste 200
Kingsport, TN 37660
Phone (423) 578-7878

NPI Registry JSON

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1972429348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 MEADOWVIEW PKWY STE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607388",
            "telephone_number": "423-678-1399",
            "fax_number": "423-259-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 MEADOWVIEW PKWY STE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607388",
            "telephone_number": "423-678-1399",
            "fax_number": "423-259-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF KINGSPORT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "VITO CRUZ",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-870-1699",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.