NPIMap

Organization Active NPI

Orange Grove Center, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Hixson, TN
National Provider Identifier
1255540993
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
3230961565 Issued in TN
Legal business name
ORANGE GROVE CENTER, INC
Practice address
1524 Shelby Cir
Hixson, TN 37343-3025
Phone
(423) 629-1451
Fax
(423) 624-1294
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Ms. Tera Roberts
Title
Executive Director
Phone
(423) 629-1451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 3230961565 TN Primary

Addresses

Primary practice location

1524 Shelby Cir
Hixson, TN 37343-3025

Mailing address

615 Derby St
Chattanooga, TN 37404-1632
Phone (423) 629-1451

Other identifiers 1

IdentifierTypeStateIssuer
7447104MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 44G087

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ORANGE GROVE CENTER SHELBY
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 28, 1995
Last certification
Feb 26, 2025
Beds
4
Ownership / control type
Private (non-profit)
Facility address
1524 Shelby Circle
Hixson, TN 37343

National Provider Directory

National Provider Directory
Tax ID family
Orange Grove Center Inc 5345 Mountain Creek22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1255540993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 DERBY ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041632",
            "telephone_number": "423-629-1451",
            "fax_number": "423-624-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 SHELBY CIR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433025",
            "telephone_number": "423-629-1451",
            "fax_number": "423-624-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE GROVE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "423-629-1451",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TN",
            "license": "3230961565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447104",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.