NPIMap

Organization Active NPI

Sequel Schools LLC Dba Kingston Academy

  • Psychiatric Residential Treatment Facility
  • Kingston, TN
National Provider Identifier
1245398908
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
L000000008435 Issued in TN
Legal business name
SEQUEL SCHOOLS LLC DBA KINGSTON ACADEMY
Practice address
183 Fiddler'S Lane
Kingston, TN 37763-4020
Phone
(865) 376-2296
Fax
(865) 376-0369
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Authorized official

Name
Russell Lee Hembree, BA
Title
Executive Director
Phone
(865) 376-2296

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X L 2(37)M3-016-1155 TN
Psychiatric Residential Treatment Facility 323P00000X L000000008435 TN Primary

Addresses

Primary practice location

183 Fiddler'S Lane
Kingston, TN 37763-4020

Mailing address

1131 Eagletree Lane
Huntsville, AL 35801-6478
Phone (256) 880-3339

Other identifiers 2

IdentifierTypeStateIssuer
1440370MedicaidTN
3810000021MedicaidWV

Other names 1

  • Camelot of Tennessee Other name

National Provider Directory

National Provider Directory
Tax ID family
Sequel Schools LLC Dba Sequelcare of Tennessee9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1245398908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 EAGLETREE LANE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016478",
            "telephone_number": "256-880-3339",
            "fax_number": "256-880-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 FIDDLER'S LANE",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634020",
            "telephone_number": "865-376-2296",
            "fax_number": "865-376-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL SCHOOLS LLC DBA KINGSTON ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "865-376-2296",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "L 2(37)M3-016-1155",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "L000000008435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1440370",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000021",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot of Tennessee",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingston, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.