Individual ProviderKelly KahleFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address102 E Ravine Rd, Kingsport, TN 37660-3814(423) 245-9600PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Kahle is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 2:46 PM.Profile DetailsProvider ID1346601259Provider TypeIndividualFull NameKahle, KellyCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date3/19/2016Last Updated1/18/2024Contact InformationPractice LocationPractice Address102 E Ravine Rd, Kingsport, TN 37660-3814Phone(423) 245-9600FaxUnlisted FaxMailing LocationMailing AddressPO Box 699, Mountain Home, TN 37684-0699PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD57672TennesseeProvider IdentifiersIDDescriptionIssuerIDQ042994DescriptionMedicaidIssuerUnlistedTennessee