Holston NH Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0000000264 Issued in TN

Legal business name

HOLSTON NH OPERATIONS LLC

Doing business as

Holston Manor

Practice address

3641 Memorial Blvd
Kingsport, TN 37664-3422

Phone

(423) 246-2411

Fax

(423) 246-8997

NPI assigned

Jul 9, 2008

Organization subpart

No

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

Authorized official

Name

Rhonda B Nelson

Title

Controller

Phone

(864) 578-6599

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Holston Manor Doing business as

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1356504393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 MEMORIAL BLVD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643422",
            "telephone_number": "423-246-2411",
            "fax_number": "423-246-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 MEMORIAL BLVD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643422",
            "telephone_number": "423-246-2411",
            "fax_number": "423-246-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLSTON NH OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "864-578-6599"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445295",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440436",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holston Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holston Manor SNF Operations LLC
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• Holston Medical Group, PC (Med Plaza Orthopaedics)
• Holston Pediatric and Adolescent Care
• Holston Regional Alternative Medicine
• Holston Regional Comprehensive Medicine
• Holston Valley Ambulatory Surgery Center, LLC
• Holston Valley Imaging Center

• Skilled Nursing Facility in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.