Southeast Tennessee Health Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTHEAST TENNESSEE HEALTH CLINIC, LLC

Practice address

7480 Ziegler Rd Ste 150
Chattanooga, TN 37421-4947

Phone

(423) 933-2001

NPI assigned

Nov 10, 2022

Last updated

Nov 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Welton Wayne Wilson

Title

Manager

Phone

(281) 429-8526

Specialties & licenses 1

Addresses

Tax ID family

Southeast Tennessee Health Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southeast Tennessee Health Clinic, LLC

  • Primary Care Clinic/Center
  • Knoxville, TN
  • NPI 1154048072
  NPD tax ID

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1083322838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "832-585-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7480 ZIEGLER RD STE 150",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214947",
            "telephone_number": "423-933-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TENNESSEE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WELTON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-429-8526"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Ambulance, LLC
• Southeast Center for Regenerative Wound Care PC
• Southeast Community Service Agency
• Southeast Eye Specialists PLLC
• Southeast Surgical Solutions LLC
• Southeast Tennessee Human Resource Agency/Hamilton County
• Southeast Tennessee Spine and Nerve Institute PLLC
• Southeast Transportation, LLC
• Southeastern Behavioral Health
• Southeastern Emergency Services of Memphis, P.C.

• Primary Care Clinic/Center in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.