NPIMap

Organization Active NPI

Campbell County Hma, LLC

Doing business as Tennova LaFollette Medical Center Clinic

  • Family Medicine Physician
  • La Follette, TN
National Provider Identifier
1235411554
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAMPBELL COUNTY HMA, LLC
Doing business as
Tennova LaFollette Medical Center Clinic
Practice address
905 E Central Ave
La Follette, TN 37766-2768
Phone
(423) 907-1600
Fax
(423) 907-1646
NPI assigned
Sep 13, 2011
Last updated
May 16, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Authorized official

Name
Mr. James P Wright
Title
Director
Phone
(615) 778-1502

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

905 E Central Ave
La Follette, TN 37766-2768

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 778-8071

Other names 1

  • Tennova LaFollette Medical Center Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111019000020 TN Part B Supplier - Clinic/Group Practice 3173795168 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
Practice locations: Caryville, TN; Clinton, TN; La Follette, TN; Lafollette, TN

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Campbell County Hma LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

140 John McGhee Blvd
Caryville, TN 37714
Phone (865) 647-1876

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1235411554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-778-8071",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662768",
            "telephone_number": "423-907-1600",
            "fax_number": "423-907-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL COUNTY HMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH MANAGEMENT ASSOCIATES, INC.",
        "enumeration_date": "2011-09-13",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-778-1502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennova LaFollette Medical Center Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Follette, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.