Individual ProviderParvati AnanthulaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2033 Meadowview Ln, Ste 200, Kingsport, TN 37660-7569(423) 857-2260(423) 857-2066PECOS EnrollmentBased on the most recent information from CMS, provider Parvati Ananthula 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 4:18 PM.Profile DetailsProvider ID1669475448Provider TypeIndividualFull NameAnanthula, ParvatiTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date5/24/2005Last Updated9/16/2009Contact InformationPractice LocationPractice Address2033 Meadowview Ln, Ste 200, Kingsport, TN 37660-7569Phone(423) 857-2260Fax(423) 857-2261Mailing LocationMailing AddressPO Box 9, Kingsport, TN 37662-0009Phone(423) 857-2066Fax(423) 857-2070Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD 36850TennesseeCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense0101242469VirginiaProvider IdentifiersIDDescriptionIssuerID3888528DescriptionMedicaidIssuerUnlistedTennessee