Shelbyville Hospital Company LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

000000002 Issued in TN

Legal business name

SHELBYVILLE HOSPITAL COMPANY LLC

Doing business as

Tennova Family Care- Wartrace

Practice address

507 Blackman Blvd W
Wartrace, TN 37183-2210

Phone

(931) 389-0600

NPI assigned

Aug 31, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SHELBYVILLE HOSPITAL COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Paula M Lalor

Title

Director/Delegated Official

Phone

(615) 925-4565

Specialties & licenses 1

Addresses

Other names 1

• Tennova Family Care- Wartrace Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Lynchburg Family Medicine

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Vanderbilt Bedford Hospital, LLC

  dba Vanderbilt Integrated Primary Care Wartrace

  • Rural Health Clinic/Center
  • Wartrace, TN
  • NPI 1659970549

  Sold to, 2021-01-01

  CMS change of ownership

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376061275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BLACKMAN BLVD W",
            "city": "WARTRACE",
            "state": "TN",
            "postal_code": "371832210",
            "telephone_number": "931-389-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 BLACKMAN BLVD W",
            "city": "WARTRACE",
            "state": "TN",
            "postal_code": "371832210",
            "telephone_number": "931-389-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBYVILLE HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBYVILLE HOSPITAL COMPANY LLC",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TN",
            "license": "000000002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennova Family Care- Wartrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy Michelle Burris, MPH
• Courtney Eichelberger
• Elysian Farms Counseling, LLC
• Ellaleigh Bjork Hall
• Lacy Moore, FNP
• Shelbyville Hospital Company LLC (Tennova Family Care-Wartrace)
• Shelbyville Hospital Corporation (Wartrace Family Practice Center)
• Shelbyville Hospital Corporation (Wartrace Family Practice Clinic)
• Shouthern Transport, LLC
• Vanderbilt Bedford Hospital, LLC (Vanderbilt Integrated Primary Care Wartrace)

• Rural Health Clinic/Center in Wartrace, TN
• Providers in Wartrace, TN by specialty
• Rural Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.