Provider Demographics
NPI:1467457861
Name:PLEMMONS WINFIELD, RITA ELIZABETH TREANOR (MD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:ELIZABETH TREANOR
Last Name:PLEMMONS WINFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ELIZABETH TREANOR
Other - Last Name:PLEMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:105 W STONE DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3365
Mailing Address - Country:US
Mailing Address - Phone:423-408-7220
Mailing Address - Fax:423-408-7405
Practice Address - Street 1:316 MARKETPLACE DR
Practice Address - Street 2:SUITE 20
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8934
Practice Address - Country:US
Practice Address - Phone:423-433-6370
Practice Address - Fax:423-610-0045
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258467207Q00000X
TN32120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3847057Medicaid
3138238OtherBCBST
3703868Medicare PIN
TN103I082867Medicare PIN
TN3847057Medicaid
TN3847057Medicare PIN
3847057Medicare PIN
G11045Medicare UPIN
3703865Medicare UPIN
080146355Medicare PIN