NPIMap

Organization Active NPI

State of Tennessee State F & a Payroll

Doing business as Moccasin Bend Mental Health Inst

  • Long Term Care Pharmacy
  • Chattanooga, TN
National Provider Identifier
1104869486
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
L2(16)M21051098 Issued in TN
Legal business name
STATE OF TENNESSEE STATE F & A PAYROLL
Doing business as
Moccasin Bend Mental Health Inst
Practice address
100 Moccasin Bend Rd
Chattanooga, TN 37405-4415
Phone
(423) 785-3321
Fax
(423) 785-3454
NPI assigned
Jun 14, 2006
Last updated
Oct 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Authorized official

Name
Jason CarterNPI 1851458129
Title
Chief of Pharmacy
Phone
(615) 532-6736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X L2(16)M21051098 TN Primary

Addresses

Primary practice location

100 Moccasin Bend Rd
Chattanooga, TN 37405-4415

Mailing address

100 Moccasin Bend Rd
Chattanooga, TN 37405-4415
Phone (423) 785-3321

Other names 1

  • MOCCASIN BEND MENTAL HEALTH INST Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bristol Health Center203 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1104869486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOCCASIN BEND RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054415",
            "telephone_number": "423-785-3321",
            "fax_number": "423-785-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MOCCASIN BEND RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054415",
            "telephone_number": "423-785-3321",
            "fax_number": "423-785-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE STATE F & A PAYROLL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF OF PHARMACY",
        "authorized_official_telephone_number": "615-532-6736"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "L2(16)M21051098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOCCASIN BEND MENTAL HEALTH INST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.