Organization Active NPI

Sullivan Health Department

  • Case Manager/Care Coordinator
  • Blountville, TN
National Provider Identifier
1164626412
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
SULLIVAN HEALTH DEPARTMENT
Practice address
154 Blountville Bypass
Blountville, TN 37617
Phone
(423) 279-2657
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Angela Eaton
Title
Tenndercare Coordintor II
Phone
(423) 279-2657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

154 Blountville Bypass
Blountville, TN 37617

Mailing address

2201 Bay St
Bristol, TN 37620-1841
Phone (423) 279-2657

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164626412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 BAY ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201841",
            "telephone_number": "423-279-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 BLOUNTVILLE BYPASS",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "37617",
            "telephone_number": "423-279-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "TENNDERCARE COORDINTOR II",
        "authorized_official_telephone_number": "423-279-2657"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blountville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.