NPIMap

Organization Active NPI

State of Tennessee

Doing business as North Rutherford County Health Department

  • Public Health or Welfare Agency
  • Smyrna, TN
National Provider Identifier
1366595134
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF TENNESSEE
Doing business as
North Rutherford County Health Department
Practice address
108 David Collins Dr
Smyrna, TN 37167-2813
Phone
(615) 355-6175
Fax
(615) 459-7996
NPI assigned
Jan 18, 2007
Last updated
Aug 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Mrs. Annette Haley
Title
Regional Director
Phone
(615) 650-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X TN Primary

Addresses

Primary practice location

108 David Collins Dr
Smyrna, TN 37167-2813

Mailing address

108 David Collins Dr
Smyrna, TN 37167-2813
Phone (615) 355-6175

Other identifiers 1

IdentifierTypeStateIssuer
4448205MedicaidTN

Other names 1

  • North Rutherford County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001259 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5698687077 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Loudon County Health de202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1366595134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 DAVID COLLINS DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371672813",
            "telephone_number": "615-355-6175",
            "fax_number": "615-459-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 DAVID COLLINS DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371672813",
            "telephone_number": "615-355-6175",
            "fax_number": "615-459-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "615-650-7000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448205",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Rutherford County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.