NPIMap

Organization Active NPI

Wellmont Hawkins County Memorial Hospital Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Rogersville, TN
National Provider Identifier
1245260660
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC.
Practice address
851 Locust St
Rogersville, TN 37857
Phone
(423) 921-7000
Fax
(423) 921-7022
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Mary Lynn Krutak
Title
Evp/Cfo
Phone
(423) 302-3423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

851 Locust St
Rogersville, TN 37857

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2026
Phone (423) 921-7000

Other names 1

  • Hawkins County Memorial Hospital Swing Bed Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4485 W Stone Dr
Kingsport, TN 37660
Phone (423) 578-8500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1245260660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "423-921-7000",
            "fax_number": "423-921-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 LOCUST ST",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "37857",
            "telephone_number": "423-921-7000",
            "fax_number": "423-921-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "KRUTAK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "423-302-3423"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1340.1",
            "affiliationName": "WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "1.5, 1.6",
            "address_1": "851 Locust St",
            "city": "Rogersville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hawkins County Memorial Hospital Swing Bed",
            "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 21, 2021; 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.