Provider Demographics
NPI:1215341383
Name:NHC HEALTHCARE-KINGSPORT LLC
Entity type:Organization
Organization Name:NHC HEALTHCARE-KINGSPORT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:NASON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:865-690-9900
Mailing Address - Street 1:2300 PAVILION DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4622
Mailing Address - Country:US
Mailing Address - Phone:423-765-9655
Mailing Address - Fax:
Practice Address - Street 1:2300 PAVILION DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4622
Practice Address - Country:US
Practice Address - Phone:423-765-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-17
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
6033454OtherANTHEM VA
6033454OtherBLUE CROSS BLUE SHIELD TN
6033454OtherANTHEM VA