NPIMap

Organization Active NPI

Frontier Health

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bristol, TN
National Provider Identifier
1073735643
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
L 324-076-1411 Issued in TN
Legal business name
FRONTIER HEALTH
Practice address
719 Kentucky Ave
Bristol, TN 37620-3806
Phone
(423) 968-2532
NPI assigned
May 3, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Kristie Hammonds
Title
President and Ceo
Phone
(423) 467-3600

Corporate family (same tax ID) 16

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

National Provider Directory

National Provider Directory
Tax ID family
Lee County Integrated Care (62 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X L 324-076-1411 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

719 Kentucky Ave
Bristol, TN 37620-3806

Mailing address

PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600

Other names 2

NPPES NPI Registry
  • FAIRMOUNT GROUP HOME Doing business as
  • Faimount Group Home Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2020.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1073735643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9054",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376159054",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 KENTUCKY AVE",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376203806",
            "telephone_number": "423-968-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HAMMONDS",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "423-467-3600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TN",
            "license": "L 324-076-1411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRMOUNT GROUP HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Faimount Group Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Faimount Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.