Kingsport Ambulatory Surgery Ctr
NPI 1053404574 · Ambulatory Surgical Clinic/Center · Kingsport, TN
Kingsport Ambulatory Surgery Ctr is a Ambulatory Surgical Clinic/Center organization in Kingsport, TN (NPI 1053404574).
Provider details
- NPI number
- 1053404574
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jenetha Moran, Officer/Authorized Official(972) 763-3893
- License
- 0000000113 (TN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Kingsport Day Surgery
- Doing business as
- Kingsport Day Surgery
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2020-01-14
- Certified
- 2020-01-14
Frequently asked questions
- What is Kingsport Ambulatory Surgery Ctr's NPI number?
- Kingsport Ambulatory Surgery Ctr's National Provider Identifier (NPI) is 1053404574, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kingsport Ambulatory Surgery Ctr?
- Kingsport Ambulatory Surgery Ctr is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kingsport Ambulatory Surgery Ctr located?
- Kingsport Ambulatory Surgery Ctr's practice location on file with NPPES is 2204 Pavilion Drive, Kingsport, TN 37660-4653.
- What is Kingsport Ambulatory Surgery Ctr's phone number?
- The practice phone number listed in the NPPES registry for Kingsport Ambulatory Surgery Ctr is (423) 857-6300.
- Who is the authorized official for Kingsport Ambulatory Surgery Ctr?
- The authorized official listed on Kingsport Ambulatory Surgery Ctr's NPPES record is Jenetha Moran, Officer/Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kingsport Ambulatory Surgery Ctr's NPI active?
- Yes — Kingsport Ambulatory Surgery Ctr's NPI (1053404574) is active in the NPPES registry as of the last update on 2020-01-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.