TABITHA KANESHIRO PA-C
NPI 1386455871
Physician Assistant - Surgical in Kingsport, TN

Active since January 15, 2025PECOS EnrolledAccepts Medicare Assignment
2050 MEADOWVIEW PKWY, KINGSPORT, TN 37660(423) 230-5000 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2026, Apr 6, 2026, May 9, 2025 (3 updates tracked since 2025).

About Tabitha Kaneshiro Pa-c NPPES

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

TABITHA KANESHIRO PA-C (NPI 1386455871) is an individual surgical provider in Kingsport, Tennessee, licensed in Tennessee (6417) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS, is affiliated with Wellmont Holston Valley Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1386455871
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameTABITHA KANESHIROCredential: PA-C
Location Address2050 MEADOWVIEW PKWYKingsport, TN 37660-7475
Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 952-2111
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 15, 2025
Last NPPES UpdateMay 4, 20263 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
NPI 1386455871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in TN · 6417
Also ListedPhysician AssistantTaxonomy 363A00000X · License 6417 (TN)
2050 MEADOWVIEW PKWY, Kingsport, TN 37660

Secondary Practice Locations 2

Location 1746 High Point WayKnoxville, TN 37912-3693 · Phone (808) 646-1139
Location 2310 N State Of Franklin Rd Ste 400Johnson City, TN 37604-6051 · Phone (423) 979-6000

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Tabitha Kaneshiro Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7719404193
PECOS Enrollment IDI20250508002607
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440017
Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County
Emergency services

Indian Path Community Hospital

Acute Care Hospitals · Kingsport, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440176
Location2000 Brookside DrKingsport, TN 37660 · Sullivan County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Family)
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Physician Assistant
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Clinical Nurse Specialist
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Nurse Practitioner (Acute Care)
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Thoracic Surgery (Cardiothoracic Vascular Surgery)
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Nurse Practitioner (Adult Health)
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Physician Assistant (Surgical)
2050 MEADOWVIEW PKWY
KINGSPORT, TN 37660
Nurse Practitioner (Family)
2050 MEADOWVIEW PKWY
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 Tabitha Kaneshiro's NPI number?

The NPI number for Tabitha Kaneshiro is 1386455871. It was assigned to this individual provider in the NPPES registry on January 15, 2025.

Where is Tabitha Kaneshiro located?

Tabitha Kaneshiro practices at 2050 Meadowview Pkwy, Kingsport, TN 37660. The listed phone number is (423) 230-5000.

What is Tabitha Kaneshiro's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Tabitha Kaneshiro enrolled in Medicare?

Yes. Tabitha Kaneshiro is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tabitha Kaneshiro 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 2 other insurers list Tabitha Kaneshiro 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.

Is Tabitha Kaneshiro affiliated with any hospitals?

According to CMS data, Tabitha Kaneshiro is affiliated with Wellmont Holston Valley Medical Center and Indian Path Community Hospital.

When was this NPI record last updated?

The NPPES record for Tabitha Kaneshiro was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.