Look up the most recent NPI and PECOS records

Andy Delwadia

Family Medicine

Allopathic & Osteopathic Physicians

444 Clinchfield Street, Suite 201, Kingsport, TN 37660-3606

PECOS Enrollment

Based on the most recent information from CMS, provider Andy Delwadia is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1629089784
Provider Type
Individual
Full Name
Delwadia, Andy
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
8/11/2006
Last Updated
1/4/2024

Contact Information

Practice Location

444 Clinchfield Street, Suite 201, Kingsport, TN 37660-3606

(423) 230-2500

(423) 230-7502

Mailing Location

3021 Azalea Dr, Indian Land, SC 29707-5860

(423) 502-8886

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 14815 Tennessee
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 14815 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 3006294	Description Medicaid	Issuer Unlisted Tennessee
ID P00194762	Description Other	Issuer RAIL ROAD MEDICARE Tennessee
ID 010118069	Description Medicaid	Issuer Unlisted Virginia

Andy Delwadia

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

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License

Provider Identifiers

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Bates, Chad

Shafer, Jennifer Gordon

Blue Ridge Medical Management Corp

Pizzola, Jason Laurence

Galletti, Christopher

Hicks, Mack L

Vincent, Bruce S

Hubbs, Emily

Barakam, Neha

Dr Susanne Toyne Md Pllc