| Kathleen Deponte, MD | |
|
935 Virginia Ave Nw, Norton, VA 24273-1818 | |
| (276) 679-2729 | |
| (276) 679-0578 |
| Full Name | Kathleen Deponte |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 45 Years |
| Location | 935 Virginia Ave Nw, Norton, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104024256 | NPI | - | NPPES |
| 007200781 | Medicaid | VA | |
| 64794456 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 35177 (Virginia) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD35510 (Tennessee) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lonesome Pine Hospital | Big stone gap, VA | Hospital |
| Franklin Woods Community Hospital | Johnson city, TN | Hospital |
| Sycamore Shoals Hospital | Elizabethton, TN | Hospital |
| Johnson City Medical Center | Johnson city, TN | Hospital |
| Indian Path Community Hospital | Kingsport, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blue Ridge Radiology Pc | 7416860473 | 70 |
| Blue Ridge Radiology Pc | 7416860473 | 70 |
| Entity Name | Mountain Empire Radiology Inc Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093762759 PECOS PAC ID: 4688655392 Enrollment ID: O20160712002167 |
| Entity Name | Blue Ridge Radiology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881687689 PECOS PAC ID: 7416860473 Enrollment ID: O20200519001605 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Deponte, MD 1301 Sunset Dr, Ste 3, Johnson City, TN 37604-7906 Ph: (423) 979-5610 | Kathleen Deponte, MD 935 Virginia Ave Nw, Norton, VA 24273-1818 Ph: (276) 679-2729 |
J'andre O Ward, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 100 15th St Nw, Norton, VA 24273 Phone: 276-679-9668 | |
Srikumar Gopalan, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 101 15th St Nw, Norton, VA 24273 Phone: 276-328-2511 |