LIVING WATER VEIN INSTITUTE P.C. NPI 1134782170

NPI Information

NPI: 1134782170
Provider Name: LIVING WATER VEIN INSTITUTE, P.C.
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2800 PEOPLES ST STE 80
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 631-0101
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LIVING WATER VEIN INSTITUTE, P.C. is a cardiovascular disease internal medicine in Johnson City, TN. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. LIVING WATER VEIN INSTITUTE, P.C. NPI is 1134782170. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2800 PEOPLES ST STE 80
JOHNSON CITY, TN
ZIP 37604-158
Phone: (423) 631-0101
Fax: (423) 328-9027

The provider's authorized official is John F Berry .
The authorized official title is Medical Director and has the following contact phone number (423) 631-0101.

The enumeration date for this NPI number is 4/16/2019 and was last updated on 8/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10704871	OTHER		CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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