Active NPI
Scott County Community Hospital, Inc.
Doing business as Big South Fork Medical Center
- Emergency Medicine Physician
- Oneida, TN
National Provider Identifier
1124536990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- SCOTT COUNTY COMMUNITY HOSPITAL, INC.
- Doing business as
- Big South Fork Medical Center
- Practice address
- 18797 Alberta St
Oneida, TN 37841-2127 - Phone
- (423) 569-8521
- Fax
- (423) 286-5306
- NPI assigned
- Jan 16, 2018
- Last updated
- Aug 5, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kristin Wilber
- Title
- Executive Assistant
- Phone
- (423) 286-5307
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Hospitalist Physician | 208M00000X | |||
| Physician Assistant | 363A00000X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
18797 Alberta St
Oneida, TN 37841-2127
Mailing address
18797 Alberta St
Oneida, TN 37841-2127
Phone (423) 569-8521
Other names 1
- Big South Fork Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, CO, WI, OR, CA, WA, MA, GA, NV, ID, MS, TX, OH, VA, HI, FL
Enrollment records 16
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180327002959 | TN | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 32 practitioners Practice locations: Jellico, TN; Oneida, TN |
| O20240823000083 | CO | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 5 practitioners Practice locations: Colorado Springs, CO; Parker, CO; Grand Junction, CO; Denver, CO |
| O20240823002758 | WI | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Beloit, WI |
| O20240826000609 | OR | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: La Grande, OR |
| O20240827002217 | CA | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 3 practitioners Practice locations: San Diego, CA |
| O20240912003392 | WA | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 2 practitioners Practice locations: Bellevue, WA; Liberty Lake, WA |
| O20240919000865 | MA | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Lexington, MA |
| O20240926001475 | GA | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Augusta, GA; Clayton, GA |
| O20241008003126 | NV | Part B Supplier - Hospital Department(S) | 3375829112 | Practice locations: Reno, NV |
| O20241009002739 | ID | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 2 practitioners Practice locations: Coeur D Alene, ID |
| O20241014000018 | MS | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Ridgeland, MS |
| O20241017000069 | TX | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Houston, TX |
| O20241104000565 | OH | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: New Albany, OH; Westlake, OH |
| O20241112004543 | VA | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 2 practitioners Practice locations: Falls Church, VA; Middleburg, VA |
| O20241115000949 | HI | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Kailua, HI; Honolulu, HI |
| O20260116003358 | FL | Part B Supplier - Hospital Department(S) | 3375829112 |
Receives reassigned benefits from 1 practitioner Practice locations: Atlantic Beach, FL |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Big South Fork Medical Center
- Critical Access Hospital
- Oneida, TN
- NPI 1932646049
3375829112
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 58
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.
-
- Family Nurse Practitioner
- Monterey, TN
- NPI 1558078899
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1871054668
-
- Family Nurse Practitioner
- Cookeville, TN
- NPI 1972323889
-
- Acute Care Nurse Practitioner
- Oneida, TN
- NPI 1134085202
-
- Family Nurse Practitioner
- Knoxville, TN
- NPI 1730552555
-
- Internal Medicine Physician
- Oneida, TN
- NPI 1326400854
-
- Neurology Physician
- Jamestown, TN
- NPI 1497752760
-
- Emergency Medicine Physician
- Jamestown, TN
- NPI 1932128766
-
- General Practice Physician
- Jamestown, TN
- NPI 1174558456
-
- Family Nurse Practitioner
- Seymour, TN
- NPI 1760041008
-
- Family Nurse Practitioner
- Oneida, TN
- NPI 1396359899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516060800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1754352000000",
"number": "1124536990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18797 ALBERTA ST",
"city": "ONEIDA",
"state": "TN",
"postal_code": "378412127",
"telephone_number": "423-569-8521",
"fax_number": "423-286-5306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18797 ALBERTA ST",
"city": "ONEIDA",
"state": "TN",
"postal_code": "378412127",
"telephone_number": "423-569-8521",
"fax_number": "423-286-5306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCOTT COUNTY COMMUNITY HOSPITAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-16",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A",
"authorized_official_last_name": "WILBER",
"authorized_official_first_name": "KRISTIN",
"authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
"authorized_official_telephone_number": "423-286-5307"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Big South Fork Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oneida, TN
- Aaron Roberts
- Sheena Rogers, B.S.
- Rugby Emergency Physicians LLC
- John Franklin Scates Jr., FNP
- Scott County Ambulance Service
- Scott County Community Hospital, Inc. (Big South Fork Medical Center)
- Scott County Community Hospital, Inc. (Big South Fork Medical Center)
- Scott County Hma LLC (Scott County Hospital)
- Scott County Hma LLC (Scott County Hospital)
- Scott County Medical Clinic Inc (Scott County Imaging Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.