Status Allergy Clinic of Kingsport

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MD0000015776 Issued in TN

Legal business name

STATUS ALLERGY CLINIC OF KINGSPORT

Practice address

1516 Bridgewater Dr.
Kingsport, TN 37660

Phone

(423) 247-1122

Fax

(423) 247-3856

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Nalinchandra Gopaldas Shah, MD

Title

President - MD

Phone

(423) 247-1122

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neesha Nalina Shah, MSN, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
  • NPI 1538557681
  NPD

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1972811503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3490",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-247-1122",
            "fax_number": "423-247-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 BRIDGEWATER DR.",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-247-1122",
            "fax_number": "423-247-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATUS ALLERGY CLINIC OF KINGSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "NALINCHANDRA",
        "authorized_official_middle_name": "GOPALDAS",
        "authorized_official_title_or_position": "PRESIDENT - MD",
        "authorized_official_telephone_number": "423-247-1122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "TN",
            "license": "MD0000015776",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "MD0000015776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64663172",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Gammon Starnes, PHARMD
• Madison Taylor Starnes, APRN, FNP-BC
• Tyler Carson Starnes
• Dennis Starr, MD
• Peggy Staton, FNP
• Brooke Stayer, PHARMD
• Jeffrey Stayer, MD
• Ruth Steffen, LCSW & LMFT
• Alexander Jacob Steffey, SRNA
• Phillip L Steffey, LCSW

• Allergy & Immunology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Allergy & Immunology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.