Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kingsport Ambulatory Surgery Ctr

Organization Ambulatory Surgical Clinic/Center · NPI 1053404574

Kingsport Ambulatory Surgery Ctr is an Ambulatory Surgical Clinic/Center in Kingsport, Tennessee. Licensed in Tennessee. Registered with an NPI since 2006.

Licensed in
TN
In the registry since
2006

Practice location Address checks out

2204 Pavilion Dr Ste 300
Kingsport, TN 37660-4653
Phone: (423) 857-6300
Fax: (423) 857-6324
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 0000000113 (TN)

Record details

NPI number1053404574
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenetha Moran — Officer/Authorized Official · (972) 763-3893
Other names Kingsport Day Surgery; Kingsport Day Surgery
NPI enumeratedOctober 2, 2006
Last updated in NPPESJanuary 14, 2020
Certification dateJanuary 14, 2020
Mailing address14201 Dallas Pkwy, Dallas, TX 75254-2916

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