WATERS OF KINGSPORT LLC
NPI 1306616149
Skilled Nursing Facility in Kingsport, TN

Active since January 03, 2024CLIA 44D0874210 · Waiver
100 NETHERLAND LN, KINGSPORT, TN 37660(423) 245-0360 Get Directions Write a Review

NPPES record last updated: June 15, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Waters Of Kingsport Llc NPPES

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

WATERS OF KINGSPORT LLC (NPI 1306616149) is a healthcare organization registered as a skilled nursing facility in Kingsport, Tennessee and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through August 4, 2027 and lists Jeffrey Sax, Manager, as its authorized official.

NPPES Registry Identity

NPI1306616149
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWATERS OF KINGSPORT LLC
Location Address100 NETHERLAND LNKingsport, TN 37660-7245
Mailing Address100 Netherland LnKingsport, TN 37660-7245 · (423) 245-0360
Organization SubpartNo
Authorized OfficialJeffrey SaxManager · (269) 281-4200
Enumeration DateJanuary 3, 2024
Last NPPES UpdateJune 15, 2026
NPPES CertifiedJune 15, 2026
NPI 1306616149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

100 NETHERLAND LN, Kingsport, TN 37660

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D0874210

Waters Of Kingsport LLC, The · Kingsport, TN
Active · expires Aug 4, 2027
CLIA Number44D0874210
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateAugust 5, 2025
Certificate Expiration DateAugust 4, 2027
Laboratory DirectorJennifer Woodby
Laboratory Phone(423) 849-0055
Laboratory LocationWaters Of Kingsport LLC, The100 Netherland Lane, Kingsport, TN 37660
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
100 NETHERLAND LN
KINGSPORT, TN 37660
Skilled Nursing Facility
100 NETHERLAND LN
KINGSPORT, TN 37660
Physical Therapy Assistant
100 NETHERLAND LN
KINGSPORT, TN 37660
Speech-Language Pathologist
100 NETHERLAND LN
KINGSPORT, TN 37660
General Practice
100 NETHERLAND LN
KINGSPORT, TN 37660
Occupational Therapy Assistant
100 NETHERLAND LN
KINGSPORT, TN 37660
Physical Therapist
100 NETHERLAND LN
KINGSPORT, TN 37660
Dietitian, Registered
100 NETHERLAND LN
KINGSPORT, TN 37660

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 Waters Of Kingsport LLC's NPI number?

The NPI number for Waters Of Kingsport LLC is 1306616149. It was assigned to this organization in the NPPES registry on January 3, 2024.

Where is Waters Of Kingsport LLC located?

Waters Of Kingsport LLC is located at 100 Netherland Ln, Kingsport, TN 37660. The listed phone number is (423) 245-0360.

What is Waters Of Kingsport LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Waters Of Kingsport LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0874210) is associated with this NPI, valid through August 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Waters Of Kingsport LLC was last updated on June 15, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.