Unknown Individual – Cardiovascular Disease Physician, NPI 1477516243

Unknown Individual is a healthcare provider. based in Kingsport, Tennessee. specializing in Cardiovascular Disease Physician. They hold a License No. 0101047516 (VA). The NPI Number for Unknown Individual is 1477516243

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1477516243
Phone
(423) 224-3250
Address
999 EXECUTIVE PARK BLVD
Deactivation Date
21 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 999, Executive Park Boulevard, Preston Forest, Kingsport, Sullivan County, Tennessee, 37660, United States

    SUITE 201

    KINGSPORT, TN 376604632

    Phone: (423) 224-3250

    Fax: (423) 224-3258

    Type: Mailing

  • 280, Virginia Avenue Northeast, Norton, Norton City, Virginia, 24273, United States

    SUITE 104

    NORTON, VA 242731538

    Phone: (276) 679-4128

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37660)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1477516243 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Kingsport, Tennessee. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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