Cocke County Hma LLC

Organization Active NPI Obstetrics & Gynecology Physician · Newport, TN

NPI 1104463322 · NPPES record last updated Dec 6, 2019

Key facts

NPI
1104463322
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
COCKE COUNTY HMA LLC
Practice address
434 4TH St Ste 305
Newport, TN 37821-3735
Phone
(423) 613-6381
Fax
(423) 613-6382
NPI assigned
Dec 6, 2019
Organization subpart
No

Authorized official

Name
James P Wright
Title
VP Physician Business Services
Phone
(615) 778-1502

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 2

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

Practitioners 8

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200619000776 TN Part B Supplier - Clinic/Group Practice 4183898562 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Newport, TN

National Provider Directory

Tax ID family
Cocke County Hma LLC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

434 4TH St Ste 305
Newport, TN 37821-3735

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 778-8196

Other providers in Newport, TN

All providers in Newport, TN · Obstetrics & Gynecology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.