TENNESSEE CANCER SPECIALIST PLLC - NPI 1659112662 - Internal Medicine in Kingsport, TN

Q: What is Tennessee Cancer Specialist PLLC's NPI number?

The NPI number for Tennessee Cancer Specialist PLLC is 1659112662. It was assigned to this organization in the NPPES registry on June 4, 2024.

Q: What is Tennessee Cancer Specialist PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

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About Tennessee Cancer Specialist Pllc NPPES

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

TENNESSEE CANCER SPECIALIST PLLC (NPI 1659112662) is a healthcare organization registered as a hematology & oncology in Kingsport, Tennessee and active in the NPI registry since June 2024. The organization holds a CLIA Certificate of Compliance certificate valid through October 20, 2026 and lists Patricia G Jenkins, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1659112662

Entity TypeOrganization

Primary Taxonomy207RH0003X

Legal Business NameTENNESSEE CANCER SPECIALIST PLLC

Location Address4 SHERIDAN SQ STE 102Kingsport, TN 37660-7435

Mailing Address6016 Brookvale Ln Ste 200Knoxville, TN 37919-4092 · (865) 862-0998 · Fax (865) 544-1861

Phone(423) 588-7140

Fax(423) 588-7141

Organization SubpartNo

Authorized OfficialPatricia G JenkinsCredentialing Coordinator · (865) 862-0998

Enumeration DateJune 4, 2024

Last NPPES UpdateApril 21, 2025

NPPES CertifiedApril 21, 2025

✔ NPI 1659112662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

4 SHERIDAN SQ STE 102, Kingsport, TN 37660

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Compliance 44D2307956

Tennessee Cancer Specialists · Kingsport, TN

Active · expires Oct 20, 2026

CLIA Number44D2307956

Laboratory TypePhysician Office

Certificate Effective DateOctober 21, 2024

Certificate Expiration DateOctober 20, 2026

Laboratory DirectorDr. Kanishka Chakraborty

Laboratory Phone(423) 588-7140

Laboratory LocationTennessee Cancer Specialists4 Sheridan Square, Suite 102, Kingsport, TN 37660

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

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

KELLY NICOLE JACKSON FNP

Nurse Practitioner (Family)