Tennessee Clinical Schools, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

L2373M30369353 Issued in TN

Legal business name

TENNESSEE CLINICAL SCHOOLS, LLC

Doing business as

Hermitage Hall

Practice address

1220 8TH Ave S
Nashville, TN 37203-5004

Phone

(615) 742-3000

Fax

(615) 742-3701

NPI assigned

Jul 19, 2006

Last updated

Jul 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Etta Jette

Title

Administrator

Phone

(615) 386-7232

Specialties & licenses 1

Addresses

Other names 1

• Hermitage Hall Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215956446. Details of each certification follow.

• CCN 44L016 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 44L016

Legal name

HERMITAGE HALL

Certification status

Active

Provider type (POS)

Psychiatric residential treatment facility

Participating since

Oct 14, 2004

Last certification

Sep 22, 2021

Beds

100

Ownership / control type

Non-profit – corporation

Facility address

1220 8TH Avenue South
Nashville, TN 37203

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Gladys Ann Bush, M.D.

  • Psychiatry Physician
  • Nashville, TN
  • NPI 1710950514
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1215956446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 8TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035004",
            "telephone_number": "615-742-3000",
            "fax_number": "615-742-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 8TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035004",
            "telephone_number": "615-742-3000",
            "fax_number": "615-742-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CLINICAL SCHOOLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "JETTE",
        "authorized_official_first_name": "ETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "615-386-7232"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "L2373M30369353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hermitage Hall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric Residential Treatment Facility in Nashville, TN
• Providers in Nashville, TN by specialty
• Psychiatric Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.