OrganizationCenterpoint Medical Clinic LlcFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2020 Brookside Drive, Suite 20, Kingsport, TN 37660(423) 247-7030PECOS EnrollmentBased on the most recent information from CMS, provider Centerpoint Medical Clinic Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1295778538Provider TypeOrganizationFull NameCenterpoint Medical Clinic LlcSubpartNoEnumeration Date6/14/2006Last Updated9/9/2011Contact InformationPractice LocationPractice Address2020 Brookside Drive, Suite 20, Kingsport, TN 37660Phone(423) 247-7030Fax(423) 247-7033Mailing LocationMailing AddressPO Box 4842, Johnson City, TN 37602-4842Phone(423) 247-7030Fax(423) 247-7033Authorized OfficialNameBone, Ina K (Np/Co-Owner)Phone(423) 247-7030Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerTennesseeProvider IdentifiersIDDescriptionIssuerID3721007DescriptionMedicaidIssuerUnlistedTennessee