NPIMap

Organization Active NPI

Erlanger Health

  • Medicare Defined Swing Bed Hospital Unit
  • Pikeville, TN
National Provider Identifier
1073216370
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ERLANGER HEALTH
Practice address
71 Wheelertown Ave
Pikeville, TN 37367-5246
Phone
(423) 447-2112
NPI assigned
Mar 24, 2023
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ERLANGER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Lynn Dejaco
Title
Cfo, Evp
Phone
(423) 778-7212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

71 Wheelertown Ave
Pikeville, TN 37367-5246

Mailing address

71 Wheelertown Ave
Pikeville, TN 37367-5246
Phone (423) 447-2112

Other names 1

  • BLEDSOE HOSPITAL SWINGBED Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230714001576 TN Part A Provider - Critical Access Hospital 1153780226 Practice locations: Pikeville, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073216370. Details of each certification follow.

Hospital certification: CCN 44Z306

Legal name
ERLANGER HEALTH
Doing business as
ERLANGER BLEDSOE HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jun 12, 2022 in TN
Enrollment address
71 Wheelertown Ave
Pikeville, TN 37367-5246
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Erlanger Health12 organizations share this tax ID, including this one
Part of
Erlanger Health

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Erlanger Health Organization, Chattanooga, TN Created for acquisition, Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Vicky B Gregg Individual Corporate DirectorBoard Member Jul 1, 2023
Sheila Chapnerkar Boyington Individual Corporate DirectorBoard Member Jul 1, 2023
Jim Coleman Individual Corporate OfficerCho Admin, Ceo Jul 1, 2023
Lynn S Dejaco Individual Corporate OfficerEvp, Cfo Jul 1, 2023
Jeff Woodard Individual Corporate OfficerBoard Member, Chief Legal Ofcr Jul 1, 2023
Mike Shaver Individual W-2 Managing EmployeeDirector of Reimbursement Jul 1, 2023

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Erlanger Murphy Medical CenterMurphy, NC, CCN 34Z328 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger Murphy Medical CenterMurphy, NC, CCN 341328 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger Medical CenterChattanooga, TN, CCN 440104 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger Murphy Medical Group, FamilyMurphy, NC, CCN 343459 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger MMC Urgent CareMurphy, NC, CCN 343461 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger Primary Care PeachtreeMurphy, NC, CCN 343472 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023
Erlanger Andrews Family PracticeAndrews, NC, CCN 343471 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2023

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1073216370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 WHEELERTOWN AVE",
            "city": "PIKEVILLE",
            "state": "TN",
            "postal_code": "373675246",
            "telephone_number": "423-447-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 WHEELERTOWN AVE",
            "city": "PIKEVILLE",
            "state": "TN",
            "postal_code": "373675246",
            "telephone_number": "423-447-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERLANGER HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERLANGER HEALTH",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "DEJACO",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CFO,  EVP",
        "authorized_official_telephone_number": "423-778-7212"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLEDSOE HOSPITAL SWINGBED",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BLEDSOE HOSPITAL SWINGBED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pikeville, TN

Sources for this page

Verify at the official NPI Registry.