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Patricia B. Amadio

Family Medicine

Allopathic & Osteopathic Physicians

102 E Ravine Rd, Kingsport, TN 37660-3814

PECOS Enrollment

This provider is enrolled in PECOS as PATRICIA AMADIO.

Based on the most recent information from CMS, provider Patricia B. Amadio is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 12:05 PM.

Profile Details

Provider ID
1568461382
Provider Type
Individual
Full Name
Amadio, Patricia B.
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
7/14/2005
Last Updated
7/21/2022

Contact Information

Practice Location

102 E Ravine Rd, Kingsport, TN 37660-3814

(423) 245-9600

(423) 245-9634

Mailing Location

PO Box 699, Mountain Home, TN 37684-0699

(423) 245-9634

(423) 245-9600

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 52559 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 0119261	Description Medicaid	Issuer Unlisted Mississippi

Patricia B. Amadio

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Kegley, Zachary

Crawford, Amylyn Lane

Ananthula, Parvati

Tomczyk, Jakub

Holston Medical Group Pc

Mcqueen, Kelly G

Jones, Lesley Ann

Goan, Kari Jones

Mountain Region Family Medicine, Pc

Blue Ridge Medical Management Corp