State of Tennessee
Organization Active NPI Public Health or Welfare Agency · Johnson City, TN
NPI 1245386010 · NPPES record last updated Nov 18, 2016
Key facts
- NPI
- 1245386010
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- STATE OF TENNESSEE
- Practice address
- 185 Treasure Lane
Johnson City, TN 37604 - Phone
- (423) 979-3200
- Fax
- (423) 979-3267
- NPI assigned
- Jan 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Rebekah English, RN
- Title
- Regional Director
- Phone
- (423) 979-3200
Corporate family (same tax ID) 24
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
All facility ownership & control disclosures 18
| Facility | Type | Role | Since |
|---|---|---|---|
| Middle Tennessee Mental Health Institute |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 1995 |
| Moccasin Bend Mental Health Institute |
Hospital | Operational/Managerial Control (100%) | Jul 1, 2008 |
| Stewart County Community Medical Center |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 19, 1987 |
| Overton County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Cannon County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Clay County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Cumberland County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Dekalb County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Fentress County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Jackson County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Macon County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Pickett County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Putnam County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Smith County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Van Buren County Health Department |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Other (100%) |
Apr 23, 2014 Apr 23, 2014 |
| Warren County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| White County Health Department |
Federally qualified health center | Other | Apr 23, 2014 |
| Gibson County Health Department/Community Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Aug 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250224002725 | TN | Part B Supplier - Clinic/Group Practice | 5698687077 |
Receives reassigned benefits from 1 practitioner Practice locations: Johnson City, TN |
National Provider Directory
- Tax ID family
- Trousdale County Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
185 Treasure Lane
Johnson City, TN 37604
Mailing address
185 Treasure Lane
Johnson City, TN 37604
Phone (423) 979-3200
Other names
- Northeast Tennessee Regional Health Office
Other providers in Johnson City, TN
- Kathryn Lynne Starr
- Janet Florence Stastny
- State of Franklin Healthcare Associates PLLC
- State of Franklin Healthcare Associates PLLC
- State of Tennessee
- State of Tennessee
- State of Tennessee
- State of Tennessee
- Aaron Stavrakis
- Alexandra M Steadman-Cowan
All providers in Johnson City, TN · Public Health or Welfare Agency in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.