| Kingsport Primary Care, Pc | |
|
1526 Bridgewater Ln Kingsport TN 37660-4106 | |
| (423) 246-0033 | |
| (423) 245-0034 |
| Full Name | Kingsport Primary Care, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1526 Bridgewater Ln, Kingsport, Tennessee |
| Authorized Official Name and Position | Scott D Mclain (SUPERVISING PHYSICIAN) |
| Authorized Official Contact | 4232460033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingsport Primary Care, Pc 1526 Bridgewater Ln Kingsport TN 37660-4106 Ph: (423) 246-0033 | Kingsport Primary Care, Pc 1526 Bridgewater Ln Kingsport TN 37660-4106 Ph: (423) 246-0033 |
| NPI Number | 1023186145 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 10/07/2019 |
| Medicare PECOS PAC ID | 5799709770 |
|---|---|
| Medicare Enrollment ID | O20060117000949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023186145 | NPI | - | NPPES |
| 3732429 | Medicaid | TN | |
| 3732429 | Other | TN | MEDICARE PTAN |
| 2403604 | Other | TN | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD11895 (Tennessee) | Primary |
| Provider Name | Scott D Mclain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285664839 PECOS PAC ID: 5698714129 Enrollment ID: I20050425001225 |
| Provider Name | Keith E Pratt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396773669 PECOS PAC ID: 3274561394 Enrollment ID: I20050730000130 |
| Provider Name | Jennifer M Barham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316245137 PECOS PAC ID: 7810171774 Enrollment ID: I20110418000743 |
| Provider Name | Jordan Lee Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528412301 PECOS PAC ID: 9537450069 Enrollment ID: I20160614000670 |
Wps Providers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-4000 | |
Sullivan And Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2204 Pavilion Dr Ste 108, Kingsport, TN 37660 Phone: 423-392-6100 Fax: 423-392-0803 | |
Tri-cities Gastroenterology Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10461 Wallace Alley St, Kingsport, TN 37663 Phone: 423-279-1400 | |
Kingsport Consultants Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-4000 Fax: 423-224-4693 | |
Carl E Bendeck Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1328 Belmeade Dr, Kingsport, TN 37664 Phone: 423-578-3489 | |
A. Evan Lewis Phd Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1936 Brookside Dr Ste D, Kingsport, TN 37660 Phone: 423-392-5020 Fax: 423-392-5100 |