Individual provider Active NPI

Kevin Scott Cornwell, MD

  • Pulmonary Disease Physician
  • Kingsport, TN
National Provider Identifier
1982634754
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
40735 Issued in TN
Practice address
111 W Stone Dr Ste 100
Kingsport, TN 37660-6027
Phone
(423) 247-5197
Fax
(423) 247-5254
NPI assigned
Jul 4, 2006
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD40735 TN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2020-00015 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 40735 TN
Pulmonary Disease Physician 207RP1001X 2020-00015 NC
Pulmonary Disease Physician 207RP1001X 40735 TN Primary

Addresses

Primary practice location

111 W Stone Dr Ste 100
Kingsport, TN 37660-6027

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

2209 S Sterling St Ste 600
Morganton, NC 28655-4092
Phone (828) 580-4577

Other practice location 2

378 Marketplace Blvd Ste 5
Johnson City, TN 37604-2361
Phone (423) 282-0751

Other practice location 3

16000 Johnston Memorial Dr Ste 312D
Abingdon, VA 24211-7664
Phone (276) 258-1000

Other practice location 4

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Other practice location 5

400 N State Of Franklin Rd Rm 2746
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other identifiers 1

IdentifierTypeStateIssuer
P00855262OtherTNMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070118000592 TN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6305847278 Reassigns benefits to 3 organizations
I20220623002618 VA Practitioner - Internal Medicine 6305847278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, shared by 2 NPIs, 283 clinicians

Practice addresses (Care Compare)

16000 Johnston Memorial Dr
312D
Abingdon, VA 24211-7664
Phone (276) 258-1740

400 N State of Franklin Rd
RM 2746
Johnson City, TN 37604-6035
Phone (423) 431-2727

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD40735TNMDInternal Medicine Physician
2020-00015NCMDCritical Care Medicine (Internal Medicine) Physician
40735TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
University Health System Inc CurrentSince Jul 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Internal Medicine CurrentSince May 29, 2023 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients
Wellmont Medical Associates Inc Internal Medicine Current Accepting new patients
University Health System, Inc Internal Medicine Current Accepting new patients
University Health System, Inc Pulmonary Disease CurrentSince Jul 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Apr 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Apr 1, 2022 Accepting new patients
Wellmont Medical Associates Inc Past Accepting new patients
Solstas Lab Partners Group LLC Past Accepting new patients
Inpatient Consultants of Tennessee, P.C. Internal Medicine Past Accepting new patients
Bristol Consultants PC Internal Medicine PastSince May 24, 2005 Accepting new patients

Locations

1 Medical Park Blvd
Ste 350W
Bristol, TN 37620
Phone (423) 844-4240

1497 W Elk Ave
Ste 11
Elizabethton, TN 37643
Phone (423) 542-7480

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

314 Rogosin Dr
Elizabethton, TN 37643
Phone (423) 433-6630

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

400 N State of Franklin Rd
Rm 2746
Johnson City, TN 37604
Phone (423) 431-2727

395 Forest Cir
Ste 100
Jonesborough, TN 37659
Phone (423) 753-0721

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

1940 Alcoa Hwy
Ste E210
Knoxville, TN 37920
Phone (865) 524-7471

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

16000 Johnston Memorial Dr
#312D
Abingdon, VA 24211
Phone (276) 258-1740

16000 Johnston Memorial Dr
Ste 312D
Abingdon, VA 24211
Phone (276) 258-1000

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1982634754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STONE DR STE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606027",
            "telephone_number": "423-247-5197",
            "fax_number": "423-247-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 S Sterling St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554092",
            "country_code": "US",
            "telephone_number": "828-580-4577",
            "fax_number": "828-580-4599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "378 Marketplace Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042361",
            "country_code": "US",
            "telephone_number": "423-282-0751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr Ste 312D",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd Rm 2746",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "KEVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD40735",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2020-00015",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "40735",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "2020-00015",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "40735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00855262",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.