Provider Demographics
NPI:1316748197
Name:KINGSPORT CITY SCHOOLS
Entity type:Organization
Organization Name:KINGSPORT CITY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BENEFITS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JEROLD
Authorized Official - Last Name:WESSELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-224-2606
Mailing Address - Street 1:415 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4285
Mailing Address - Country:US
Mailing Address - Phone:423-224-2606
Mailing Address - Fax:
Practice Address - Street 1:400 CLINCHFIELD ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3687
Practice Address - Country:US
Practice Address - Phone:423-378-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF KINGSPORT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)