State of Tennessee
Organization Active NPI Public Health or Welfare Agency · Altamont, TN
NPI 1275670879 · NPPES record last updated Feb 8, 2022
Key facts
- NPI
- 1275670879
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- STATE OF TENNESSEE
- Practice address
- 1372 Main Street
Altamont, TN 37301 - Phone
- (931) 692-3641
- Fax
- (931) 692-2201
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Richard W McCarthy, MBA
- Title
- Accounting Manager
- Phone
- (423) 634-5832
Corporate family (same tax ID) 24
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 |
|---|---|---|---|---|
| O20041013001259 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 5698687077 |
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
1372 Main Street
Altamont, TN 37301
Mailing address
1372 Main Street
P.O. Box 65
Altamont, TN 37301-0065
Phone (931) 692-3641
Other names
- Grundy County Health Department
Other providers in Altamont, TN
- Angela Frantz
- Grundy County Department of Education
- Angela Lynne Horner
- Rocky Top Medical Clinic LLC
- Kimberly Dawn Simmons
- Larry Arthur Wiley
- Wileys LLC
All providers in Altamont, 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 Feb 8, 2022. 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.