Organization Active NPI

Scott County Community Hospital, Inc.

Doing business as Big South Fork Medical Center

  • Emergency Medicine Physician
  • Oneida, TN
National Provider Identifier
1124536990
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

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, FL16 enrollments

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
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).

National Provider Directory

National Provider Directory

Practitioners & 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.

View all 58

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

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.

Verify at the official NPI Registry.