NPIMap

Organization Active NPI

Frontier Health

  • Psychiatric Residential Treatment Facility
  • Johnson City, TN
National Provider Identifier
1124463849
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
I000000012508 Issued in TN
Legal business name
FRONTIER HEALTH
Practice address
210 Quary Rd
Johnson City, TN 37601-7580
Phone
(423) 232-7234
Fax
(423) 467-3644
NPI assigned
May 8, 2013
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Kristie Hammonds
Title
President & Ceo
Phone
(423) 467-3600

Corporate family (same tax ID) 18

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

View all 18

Practitioners 2

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

National Provider Directory

National Provider Directory
Tax ID family
Lee County Integrated Care (62 organizations share this tax ID)

Locations

210 Quary Rd
Johnson City, TN 37601
Phone (423) 232-7234

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X I000000012508 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

210 Quary Rd
Johnson City, TN 37601-7580

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

Other names 1

NPPES NPI Registry
  • GIBSON PLACE 210 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2020.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1124463849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 QUARY RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017580",
            "telephone_number": "423-232-7234",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HAMMONDS",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "423-467-3600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "I000000012508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIBSON PLACE 210",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GIBSON PLACE 210",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.