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KINGSTON FAMILY PRACTICE, P.C.
NPI 1356432041
Family Medicine in Kingston, TN

Active since September 27, 2006CLIA 44D0311465 · Waiver
820 W RACE ST, KINGSTON, TN 37763(865) 376-3406(865) 376-9091 Get Directions Write a Review

NPPES record last updated: May 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kingston Family Practice, P.c. NPPES

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

KINGSTON FAMILY PRACTICE, P.C. (NPI 1356432041) is a healthcare organization registered as a family medicine in Kingston, Tennessee and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through February 21, 2027 and lists Dwight H Willett, President, as its authorized official.

NPPES Registry Identity

NPI1356432041
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKINGSTON FAMILY PRACTICE, P.C.
Location Address820 W RACE STKingston, TN 37763-2120
Mailing Address820 W Race StKingston, TN 37763-2120 · (865) 376-3406 · Fax (865) 376-9091
Phone(865) 376-3406
Fax(865) 376-9091
Organization SubpartNo
Authorized OfficialDwight H WillettPresident · (865) 376-3406
Enumeration DateSeptember 27, 2006
Last NPPES UpdateMay 10, 2023
NPPES CertifiedMay 10, 2023
✔ NPI 1356432041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X
820 W RACE ST, Kingston, TN 37763
Open in Google Maps ↗

Other Identifiers 3

Other080080789TN · Railroad Medicare
Other080153049TN · Railroad Medicare
Other443961TN · Riverbend Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

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 44D0311465

Kingston Family Practice PC · Kingston, TN
Active · expires Feb 21, 2027
CLIA Number44D0311465
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2025
Certificate Expiration DateFebruary 21, 2027
Laboratory DirectorDr. Dwight H. Willett
Laboratory Phone(865) 376-3406
Laboratory LocationKingston Family Practice PC820 West Race Street, Kingston, TN 37763
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

FARZANA SHARMIN IQBAL M.D.
Internal Medicine (Geriatric Medicine)
820 W RACE ST
KINGSTON, TN 37763
Roane County (865) 376-3406
MRS. BEVERLY KAY GLASURE PA
Physician Assistant
820 W RACE ST
KINGSTON, TN 37763
Roane County (865) 376-3406
DR. DOUGLAS S DEWAR M.D.
Family Medicine
820 W RACE ST
KINGSTON, TN 37763
Roane County (865) 376-3406
DWIGHT H WILLETT M.D.
Family Medicine
820 W RACE ST
KINGSTON, TN 37763
Roane County (865) 376-3406
MRS. JENNIFER GAIL DAUGHERTY FNP-C
Nurse Practitioner
820 W RACE ST
KINGSTON, TN 37763
Roane County (865) 376-3406

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 Kingston Family Practice, P.C.'s NPI number?

The NPI number for Kingston Family Practice, P.C. is 1356432041. It was assigned to this organization in the NPPES registry on September 27, 2006.

Where is Kingston Family Practice, P.C. located?

Kingston Family Practice, P.C. is located at 820 W Race St, Kingston, TN 37763. The listed phone number is (865) 376-3406.

What is Kingston Family Practice, P.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Kingston Family Practice, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0311465) is associated with this NPI, valid through February 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kingston Family Practice, P.C. accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Kingston Family Practice, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kingston Family Practice, P.C. was last updated on May 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.