KINGSTON FAMILY PRACTICE, P.C.
NPI 1356432041
Family Medicine in Kingston, TN
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
Specialties & Licenses 2
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kingston Family Practice, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kingston Family Practice, P.C., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, TNFrequently 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.
Is Kingston Family Practice, P.C. enrolled in Medicare?
Yes. Kingston Family Practice, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kingston Family Practice, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Kingston Family Practice, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee 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.
# Kingston Family Practice, P.c. · NPI 1356432041
Family Medicine organization in Kingston, Tennessee. Organization record, active in the CMS NPPES registry since September 27, 2006.
## Identity
- **NPI:** 1356432041 (Entity type: Organization)
- **Enumerated:** September 27, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Dwight Willett, PRESIDENT
## Practice location
- **Address:** 820 W RACE ST, Kingston, TN 37763-2120
- **Phone:** (865) 376-3406 · **Fax:** (865) 376-9091
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 10, 2023
- **Other identifiers:** Other 080080789 (TN); Other 080153049 (TN); Other 443961 (TN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356432041) · Data from the CMS NPPES public registry.