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Export Provider Record NPI 1205554664
Holston Medical Group, Pc
Organization Subpart: NO
Active
NPI Number1205554664
NPI TypeNPI-2 Organization
SpecialtyInternal Medicine, Sports Medicine
Provider Details
NPI1205554664
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2022-08-19
Last Updated2022-08-19
Authorized OfficialAudra Lawson
Contract Analyst
Phone: 4238572066
Mailing AddressPo Box 9
Kingsport, TN 37662-0009
United States
Phone: (423) 857-2066
📍 View Map
Primary Practice Address3019 Peoples Street, Condo 300
Johnson City, TN 37604
United States
Phone: (423) 461-2100
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No213E00000X – Podiatrist--
Yes207RS0010X – Internal Medicine, Sports Medicine--
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About NPI 1205554664

Holston Medical Group, Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1205554664. The primary specialty listed is Internal Medicine, Sports Medicine. The organization is located in Johnson City, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2022-08-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1205554664?

NPI 1205554664 belongs to Holston Medical Group, Pc, a Internal Medicine, Sports Medicine in Johnson City, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1205554664 active?

The current status of NPI 1205554664 in the NPPES registry is Active. The record was last updated on 2022-08-19.

What specialty is NPI 1205554664?

NPI 1205554664 is classified under the taxonomy Internal Medicine, Sports Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1205554664?

You can verify NPI 1205554664 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1205554664?

The primary practice address on file for NPI 1205554664 is 3019 Peoples Street, Johnson City, TN 37604. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1205554664 issued?

NPI 1205554664 was first issued (enumerated) on 2022-08-19. The NPPES record was last updated on 2022-08-19.

Practice Location Map

Holston Medical Group, Pc is located at 3019 Peoples Street, Johnson City, TN. Use the map below to find directions or verify the practice location.

📍 3019 Peoples Street, Johnson City, TN 37604  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Holston Medical Group, Pc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-07-16 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162