Active NPI
State of Tennessee
- State or Local Public Health Clinic/Center
- Rockwood, TN
National Provider Identifier
1437203809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- State or Local Public Health Clinic/Center
- Legal business name
- STATE OF TENNESSEE
- Practice address
- 1362 N Gateway Ave
Rockwood, TN 37854-4108 - Phone
- (865) 354-1220
- Fax
- (865) 354-0112
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Marianne F Sharp
- Title
- Regional Accountant
- Phone
- (865) 549-5266
Corporate family (same tax ID) 24
Organizations that report the same tax identification number in the National Provider Directory.
-
- Health Service Clinic/Center
- Huntingdon, TN
- NPI 1437454246
-
- Public Health or Welfare Agency
- Crossville, TN
- NPI 1366606915
-
- Case Management Agency
- Nashville, TN
- NPI 1437526597
-
- Public Health or Welfare Agency
- Nashville, TN
- NPI 1447618061
-
- Intellectual Disabilities Intermediate Care Facility
- Nashville, TN
- NPI 1427488154
-
- Intellectual Disabilities Intermediate Care Facility
- Hermitage, TN
- NPI 1417333568
-
- Public Health or Welfare Agency
- Jackson, TN
- NPI 1366592552
-
- Public Health or Welfare Agency
- Smyrna, TN
- NPI 1366595134
-
- Public Health or Welfare Agency
- Fairview, TN
- NPI 1386797058
-
- Clinic Pharmacy
- Jackson, TN
- NPI 1386863314
-
- Public Health or Welfare Agency
- Chattanooga, TN
- NPI 1417177528
-
- Occupational Therapist
- Nashville, TN
- NPI 1417337056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Trousdale County Health
Locations
1362 N Gateway Ave
Rockwood, TN 37854
Phone (865) 354-1220
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| State or Local Public Health Clinic/Center | 261QP0905X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1362 N Gateway Ave
Rockwood, TN 37854-4108
Mailing address
PO Box 59019
Knoxville, TN 37950-9019
Phone (865) 549-5266
Other identifiers 2
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2008151 | Other | TN | BLUECROSS BLUESHIELD |
| 4447825 | Medicaid | TN |
Other names 1
NPPES NPI Registry- Roane County Health Department
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 16, 2009.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1258329600000",
"number": "1437203809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 59019",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379509019",
"telephone_number": "865-549-5266",
"fax_number": "865-594-8919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1362 N GATEWAY AVE",
"city": "ROCKWOOD",
"state": "TN",
"postal_code": "378544108",
"telephone_number": "865-354-1220",
"fax_number": "865-354-0112"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF TENNESSEE",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-23",
"last_updated": "2009-11-16",
"status": "A",
"authorized_official_last_name": "SHARP",
"authorized_official_first_name": "MARIANNE",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "REGIONAL ACCOUNTANT",
"authorized_official_telephone_number": "865-549-5266"
},
"taxonomies": [
{
"code": "261QP0905X",
"taxonomy_group": "",
"desc": "Clinic/Center, Public Health, State or Local",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "2008151",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4447825",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Roane County Health Department",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rockwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.