NPIMap

Organization Active NPI

Rural Health Services Consortium of Upper East Tennessee Inc

Doing business as Hawkins Medical Center

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
National Provider Identifier
1013917632
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Doing business as
Hawkins Medical Center
Practice address
4966 Highway 11W
Rogersville, TN 37857-6028
Phone
(423) 272-5600
Fax
(423) 272-1428
NPI assigned
Jul 26, 2005
Last updated
Oct 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Linda W Buck
Title
Ceo
Phone
(423) 272-9163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4966 Highway 11W
Rogersville, TN 37857-6028

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 272-9163

Other identifiers 5

IdentifierTypeStateIssuer
029856300OtherBLACKLUNG
007OtherCHAMPUS PROVIDER
4122525OtherTNBLUECROSS BLUESHELD
4448147MedicaidTN
3703869OtherCIGNA/MEDICARE

Other names 1

  • Hawkins Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000207 TN Part B Supplier - Clinic/Group Practice 0941118111 Receives reassigned benefits from 54 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rogersville, TN; Sneedville, TN; Kingsport, TN

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

4966 Highway 11W
Rogersville, TN 37857
Phone (423) 272-5600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1013917632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-272-9163",
            "fax_number": "423-921-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4966 HIGHWAY 11W",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378576028",
            "telephone_number": "423-272-5600",
            "fax_number": "423-272-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-272-9163",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACKLUNG",
            "identifier": "029856300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS PROVIDER",
            "identifier": "007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHELD",
            "identifier": "4122525",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448147",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/MEDICARE",
            "identifier": "3703869",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawkins Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogersville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.