St. Mary'S Holston Health and Rehabilitation Center, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0000000333 Issued in TN

Legal business name

ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER, INC.

Practice address

3916 Boyds Bridge Pike
Knoxville, TN 37914-6233

Phone

(865) 524-1500

Fax

(865) 524-0408

NPI assigned

Feb 2, 2007

Organization subpart

Yes

Parent organization

ST. MARY'S HEALTH SYSTEM, INCAs reported in NPPES

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

Authorized official

Name

Mr. Angel David Jimenez

Title

Interim Ceo

Phone

(865) 545-7558

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

National Healthcare Corporation2 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.

• National Healthcare Corporation

  • Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1710366000
  NPD tax ID

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1083752901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 BOYDS BRIDGE PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379146233",
            "telephone_number": "865-524-1500",
            "fax_number": "865-524-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 BOYDS BRIDGE PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379146233",
            "telephone_number": "865-524-1500",
            "fax_number": "865-524-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S HEALTH SYSTEM, INC",
        "enumeration_date": "2007-02-02",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "865-545-7558",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440572",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda B Squires, MD
• Maria Srdoc, BA PSYCHOLOGY
• Veena Guruprasad Srinath, M.S.
• Susan St. Germain
• St. Mary'S Ambulatory Surgery Center LLC
• Emalee St. Pierre, PA-C
• Jeffrey Blair Staack, M.D.
• Allison Marie Staackmann, LMSW
• Corey Andrew Ernst Stack, MD
• Mia J Staehling, RBT

• Nursing Facility/Intermediate Care Facility in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Nursing Facility/Intermediate Care Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.