NPIMap

Organization Active NPI

Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hinesville, GA
National Provider Identifier
1376365197
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CENTERSTONE OF TENNESSEE, INC.
Practice address
345 W Memorial Dr
Hinesville, GA 31313-2413
Phone
(888) 291-4357
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Karen Lynette Keene
Title
VP Cybersecurity, It Security
Phone
(615) 463-6523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

345 W Memorial Dr
Hinesville, GA 31313-2413

Mailing address

345 W Memorial Dr
Hinesville, GA 31313-2413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250205001564 GA Part B Supplier - Clinic/Group Practice 9739088113 Receives reassigned benefits from 10 practitioners
Practice locations: Hinesville, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Centerstone Community M27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

345 W Memorial Dr
Hinesville, GA 31313
Phone (912) 456-2010

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1376365197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W MEMORIAL DR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313132413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W MEMORIAL DR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313132413",
            "telephone_number": "888-291-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSTONE OF TENNESSEE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "KEENE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "VP CYBERSECURITY, IT SECURITY",
        "authorized_official_telephone_number": "615-463-6523"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.