NPIMap

Organization Active NPI

Henry County Medical Center

  • Hospitalist Physician
  • Paris, TN
National Provider Identifier
1073765475
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0000000057 Issued in TN
Legal business name
HENRY COUNTY MEDICAL CENTER
Practice address
301 Tyson Ave
Paris, TN 38242-4544
Phone
(731) 642-1220
Fax
(731) 642-9588
NPI assigned
Oct 16, 2008
Last updated
Sep 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
HENRY COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Authorized official

Name
Mrs. Lisa Casteel
Title
Cfo
Phone
(731) 644-8578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0000000057 TN Primary

Addresses

Primary practice location

301 Tyson Ave
Paris, TN 38242-4544

Mailing address

PO Box 1030
Paris, TN 38242-1030
Phone (731) 642-1220

Other identifiers 1

IdentifierTypeStateIssuer
3002398MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081029000244 TN Part B Supplier - Clinic/Group Practice 6002898665 Receives reassigned benefits from 94 practitioners
1 other NPI on this enrollment
Practice locations: Paris, TN; Huntingdon, TN

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Henry County Hospital

Locations

239 Tyson Ave
Paris, TN 38242
Phone (731) 644-8208

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1073765475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382421030",
            "telephone_number": "731-642-1220",
            "fax_number": "731-642-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TYSON AVE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424544",
            "telephone_number": "731-642-1220",
            "fax_number": "731-642-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENRY COUNTY MEDICAL CENTER",
        "enumeration_date": "2008-10-16",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "CASTEEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "731-644-8578",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "0000000057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3002398",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.