NPIMap

Organization Active NPI

Rural Health Services Consortium of Upper East Tennessee Inc

Doing business as West Main Medical Center

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
National Provider Identifier
1154321966
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Doing business as
West Main Medical Center
Practice address
900 W Main St
Rogersville, TN 37857-2448
Phone
(423) 272-5202
Fax
(423) 272-4696
NPI assigned
Jul 22, 2005
Last updated
Oct 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Mrs. Linda W Buck
Title
Ceo
Phone
(423) 272-9163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

900 W Main St
Rogersville, TN 37857-2448

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 272-9163

Other identifiers 5

IdentifierTypeStateIssuer
4122525OtherTNBLUECROSS BLUESHIELD
4448314MedicaidTN
031OtherCHAMPUS PROVIDER
020366000OtherBLACKLUNG
3716673OtherCIGNA/MEDICARE

Other names 1

  • West Main Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000207 TN Part B Supplier - Clinic/Group Practice 0941118111 Receives reassigned benefits from 54 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rogersville, TN; Sneedville, TN; Kingsport, TN

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

260 Highway 11 E
Bulls Gap, TN 37711
Phone (423) 235-4191

152 Highway 143
Roan Mountain, TN 37687
Phone (423) 282-3377

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1154321966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-272-9163",
            "fax_number": "423-921-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MAIN ST",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572448",
            "telephone_number": "423-272-5202",
            "fax_number": "423-272-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-272-9163",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4122525",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448314",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS PROVIDER",
            "identifier": "031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACKLUNG",
            "identifier": "020366000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/MEDICARE",
            "identifier": "3716673",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Main Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogersville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.