KINGSPORT ENDOSCOPY CORPORATION
NPI 1578558078
Clinic/Center - Ambulatory Surgical in Kingsport, TN

NPI Status: Active since September 12, 2005

Contact Information

135 W RAVINE RD
SUITE 7A
KINGSPORT, TN
ZIP 37660
Phone: (423) 246-6777
Fax: (423) 246-7766

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 44D0859110
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 08-31-2026

About KINGSPORT ENDOSCOPY CORPORATION

This page provides the complete NPI Profile along with additional information for Kingsport Endoscopy Corporation, a provider established in Kingsport, Tennessee operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1578558078 assigned on September 2005. The practitioner's primary taxonomy code is 261QA1903X with license number 0000000055 (TN). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Mr. Mark Bartley Cpa (Chief Administrative Officer)

NPI
1578558078
Provider Name
KINGSPORT ENDOSCOPY CORPORATION
Entity Type
Organization
Location Address
135 W RAVINE RD SUITE 7A KINGSPORT, TN 37660
Location Phone
(423) 246-6777
Location Fax
(423) 246-7766
Mailing Address
135 W RAVINE RD SUITE 3A KINGSPORT, TN 37660
Mailing Phone
(423) 246-6777
Mailing Fax
(423) 246-7766
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-12-2005
Last Update Date
05-04-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
0000000055
License State
TN

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
  • BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
  • BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. MARK BARTLEY CPA

Authorized Official Title
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone
(423) 246-6777

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3287295MEDICARE ID-TYPE UNSPECIFIED (04)TN 
000815OTHER (01)VAANTHEM
36000412MEDICAID (05)KY 
100020225OTHER (01)TNPHP TENNCARE
3287295MEDICAID (05)TN 
001000993OTHER (01)TNBCBS OF TN
490001203MEDICARE ID-TYPE UNSPECIFIED (04)TNRAILROAD
007641354MEDICAID (05)VA 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 352 times for 344 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 204 times for 204 patients

Biopsy of lower large bowel using a flexible endoscope

A biopsy of the lower large bowel involves using a flexible tube with a camera (endoscope) to examine this part of your digestive tract. Small tissue samples may be taken for further examination to detect any abnormalities.

This service was performed 15 times for 15 patients

Colorectal cancer screening; colonoscopy on individual at high risk

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

This service was performed 13 times for 13 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

This service was performed 42 times for 42 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

This service was performed 121 times for 119 patients

Diagnostic exam of large bowel using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

This service was performed 164 times for 164 patients

Diagnostic exam of lower portion of large bowel using a flexible endoscope

This procedure, known as a sigmoidoscopy, involves using a flexible tube with a camera to examine the lower part of your large bowel. It helps in identifying issues like inflammation, ulcers, or abnormal growths. It's a safe, minimally invasive procedure.

This service was performed 23 times for 23 patients

Dilation of esophagus

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

This service was performed 257 times for 250 patients

Injection beneath lining of large bowel using a flexible endoscope

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

This service was performed 13 times for 13 patients

Removal of external hemorrhoids by rubber banding

Rubber band ligation is a procedure used to treat external hemorrhoids. A doctor places small rubber bands around the base of the hemorrhoids. This cuts off blood supply, causing them to shrink and fall off, typically within a week.

This service was performed 45 times for 18 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 416 times for 414 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
44D0859110
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
CHRISTOPHER MATHEWS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Kingsport Endoscopy Corporation to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1578558078, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
8
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
5
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 4 + 8 + 1 + 0 + 5 + 1 + 6 + 0 + 1 + 4 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1578558078.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Anesthesiology
135 W RAVINE RD, STE 5-B
KINGSPORT, TN 37660
Anesthesiology
135 W RAVINE RD, STE 5B
KINGSPORT, TN 37660
Anesthesiology
135 W RAVINE RD, STE 5B
KINGSPORT, TN 37660
Anesthesiology
135 W RAVINE RD, SUITE 5-B
KINGSPORT, TN 37660
Nurse Anesthetist, Certified Registered
135 W RAVINE RD, STE 5-B
KINGSPORT, TN 37660
Internal Medicine (Gastroenterology)
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Internal Medicine (Gastroenterology)
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Internal Medicine (Gastroenterology)
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Specialist
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Nurse Anesthetist, Certified Registered
135 W RAVINE RD, SUITE 5-B
KINGSPORT, TN 37660
Nurse Anesthetist, Certified Registered
135 W RAVINE RD, SUITE 5 B
KINGSPORT, TN 37660
Specialist
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Internal Medicine (Gastroenterology)
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Internal Medicine (Gastroenterology)
135 W RAVINE RD, SUITE 3A
KINGSPORT, TN 37660
Nurse Anesthetist, Certified Registered
135 W RAVINE RD, SUITE 5B
KINGSPORT, TN 37660
Nurse Anesthetist, Certified Registered
135 W RAVINE RD, STE 5B
KINGSPORT, TN 37660
Neurological Surgery
135 W RAVINE RD, SUITE 4A
KINGSPORT, TN 37660
Ophthalmology
135 W RAVINE RD, SUITE 2C
KINGSPORT, TN 37660
Ophthalmology
135 W RAVINE RD, SUITE 2C
KINGSPORT, TN 37660
Ophthalmology
135 W RAVINE RD, SUITE 2C
KINGSPORT, TN 37660

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1578558078, enumerated as an "organization" on September 12, 2005.

The provider is located at 135 W RAVINE RD SUITE 7A KINGSPORT, TN 37660 and the phone number is (423) 246-6777.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.