NPIMap

Organization Active NPI

State of Tennessee

  • Public Health or Welfare Agency
  • Trenton, TN
National Provider Identifier
1073650461
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF TENNESSEE
Practice address
1250 Manufactures Row
Trenton, TN 38382
Phone
(731) 855-7601
Fax
(731) 855-7603
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Mrs. Marilyn Barnes
Title
Regional Director
Phone
(731) 421-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1250 Manufactures Row
Trenton, TN 38382

Mailing address

PO Box 8
1250 Manufactures Row
Trenton, TN 38382
Phone (731) 855-7601

Other identifiers 1

IdentifierTypeStateIssuer
4448039MedicaidTN

Other names 1

  • Gibson County Health Department Trenton Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041013001259 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5698687077 This NPI is an additional NPI on the enrollment
O20151112001505 TN Part A Provider - Federally Qualified Health Center (FQHC) 5698687077 Practice locations: Trenton, TN

Federally qualified health center certification: CCN 441968

Legal name
STATE OF TENNESSEE
Doing business as
GIBSON COUNTY HEALTH DEPARTMENT/COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 12, 2015
Last certification
Nov 12, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
1250 Manufacturer'S Row
Trenton, TN 38382-3632

National Provider Directory

National Provider Directory
Tax ID family
Trousdale County Health202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
State of Tennessee Organization, Trenton, TN Non-profit Operational/Managerial Control Aug 1, 2015 100%
Danna Taylor Individual Corporate DirectorCounty Director Aug 1, 2015 100%
W-2 Managing EmployeeCounty Director Aug 1, 2015 100%

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
Middle Tennessee Mental Health InstituteNashville, TN, CCN 444014 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1995
Moccasin Bend Mental Health InstituteChattanooga, TN, CCN 444002 Hospital Operational/Managerial Control (100%) Jul 1, 2008
Stewart County Community Medical CenterDover, TN, CCN 441848 Federally qualified health center Operational/Managerial Control (100%) Feb 19, 1987
Overton County Health DepartmentLivingston, TN, CCN 441840 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Cannon County Health DepartmentWoodbury, TN, CCN 441828 Federally qualified health center Other Apr 23, 2014
Clay County Health DepartmentCelina, TN, CCN 441831 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Cumberland County Health DepartmentCrossville, TN, CCN 441832 Federally qualified health center Other Apr 23, 2014
Dekalb County Health DepartmentSmithville, TN, CCN 441834 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Fentress County Health DepartmentJamestown, TN, CCN 441835 Federally qualified health center Other Apr 23, 2014
Jackson County Health DepartmentGainesboro, TN, CCN 441837 Federally qualified health center Other Apr 23, 2014
Macon County Health DepartmentLafayette, TN, CCN 441838 Federally qualified health center Other Apr 23, 2014
Pickett County Health DepartmentByrdstown, TN, CCN 441841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Putnam County Health DepartmentCookeville, TN, CCN 441842 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Smith County Health DepartmentCarthage, TN, CCN 441843 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Van Buren County Health DepartmentSpencer, TN, CCN 441844 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 23, 2014
Apr 23, 2014
Warren County Health DepartmentMcMinnville, TN, CCN 441845 Federally qualified health center Other Apr 23, 2014
White County Health DepartmentSparta, TN, CCN 441847 Federally qualified health center Other Apr 23, 2014

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1073650461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "address_2": "1250 MANUFACTURES ROW",
            "city": "TRENTON",
            "state": "TN",
            "postal_code": "38382",
            "telephone_number": "731-855-7601",
            "fax_number": "731-855-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MANUFACTURES ROW",
            "city": "TRENTON",
            "state": "TN",
            "postal_code": "38382",
            "telephone_number": "731-855-7601",
            "fax_number": "731-855-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "731-421-6700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448039",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson County Health Department Trenton Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, TN

Sources for this page

Verify at the official NPI Registry.