Active NPI
Wellmont Health System, Inc
- Home Health Agency
- Kingsport, TN
National Provider Identifier
1972584092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 0000000249
- Legal business name
- WELLMONT HEALTH SYSTEM, INC
- Practice address
- 2971 Fort Henry Dr
Kingsport, TN 37664-4005 - Phone
- (423) 230-8450
- Fax
- (423) 245-7874
- NPI assigned
- Nov 7, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Carol J Kawchak
- Title
- Interim Director
- Phone
- (423) 230-8475
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 0000000249 | TN | Primary |
Addresses
Primary practice location
2971 Fort Henry Dr
Kingsport, TN 37664-4005
Mailing address
2971 Fort Henry Dr
Kingsport, TN 37664-4005
Phone (423) 230-8450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000249 | Other | TN | STATE LICENSE |
Other names 1
- Wellmont Home Care
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1972584092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2971 FORT HENRY DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376644005",
"telephone_number": "423-230-8450",
"fax_number": "423-245-7874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2971 FORT HENRY DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376644005",
"telephone_number": "423-230-8450",
"fax_number": "423-245-7874"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLMONT HEALTH SYSTEM, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KAWCHAK",
"authorized_official_first_name": "CAROL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "INTERIM DIRECTOR",
"authorized_official_telephone_number": "423-230-8475",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TN",
"license": "0000000249",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "0000000249",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Wellmont Home Care",
"code": "5",
"type": "Other Name"
}
]
}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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.