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WILLIAMS PRIMARY CARE OF TRI-CITIES, LLC
NPI 1053825075
Nurse Practitioner - Primary Care in Kingsport, TN

Active since November 29, 2017
1901 BROOKSIDE DR STE 105, KINGSPORT, TN 37660(423) 384-2820 Get Directions Write a Review

NPPES record last updated: November 29, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Williams Primary Care Of Tri-cities, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIAMS PRIMARY CARE OF TRI-CITIES, LLC (NPI 1053825075) is a healthcare organization registered as a primary care in Kingsport, Tennessee and active in the NPI registry since November 2017. The organization lists Penny Williams-cordeiro, Owner, as its authorized official.

NPPES Registry Identity

NPI1053825075
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameWILLIAMS PRIMARY CARE OF TRI-CITIES, LLC
Location Address1901 BROOKSIDE DR STE 105Kingsport, TN 37660-4617
Mailing Address1901 Brookside Dr Ste 105Kingsport, TN 37660-4617 · (423) 384-2820
Phone(423) 384-2820
Organization SubpartNo
Authorized OfficialPenny Williams-cordeiroOwner · (423) 384-2820
Enumeration DateNovember 29, 2017
✔ NPI 1053825075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in TN · BC18066
1901 BROOKSIDE DR STE 105, Kingsport, TN 37660
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Williams Primary Care Of Tri-Cities, LLC's NPI number?

The NPI number for Williams Primary Care Of Tri-Cities, LLC is 1053825075. It was assigned to this organization in the NPPES registry on November 29, 2017.

Where is Williams Primary Care Of Tri-Cities, LLC located?

Williams Primary Care Of Tri-Cities, LLC is located at 1901 Brookside Dr Ste 105, Kingsport, TN 37660. The listed phone number is (423) 384-2820.

What is Williams Primary Care Of Tri-Cities, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Williams Primary Care Of Tri-Cities, LLC was last updated on November 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.