NPIMap

Organization Active NPI

State of Tennessee

Doing business as Lakeshore Mental Health Institute

  • Psychiatric Hospital
  • Knoxville, TN
National Provider Identifier
1467538009
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
L2161051102 Issued in TN
Legal business name
STATE OF TENNESSEE
Doing business as
Lakeshore Mental Health Institute
Practice address
5908 Lyons View Pike
Knoxville, TN 37919
Phone
(865) 584-1561
Fax
(865) 450-5203
NPI assigned
Oct 27, 2006
Last updated
Mar 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Mr. Richard L Thomas
Title
Chief Executive Officer - Ceo
Phone
(865) 583-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X L2161051102 TN Primary

Addresses

Primary practice location

5908 Lyons View Pike
Knoxville, TN 37919

Mailing address

5908 Lyons View Pike
Knoxville, TN 37919
Phone (865) 584-1561

Other names 1

  • Lakeshore Mental Health Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000309 TN Part B Supplier - Clinic/Group Practice 5698687077 Receives reassigned benefits from 91 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, TN; Nashville, TN; Memphis, TN; Lebanon, TN; Cookeville, TN; Columbia, TN; Chattanooga, TN; Jackson, TN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1467538009. Details of each certification follow.

Hospital certification: CCN 440128

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LAKESHORE MENTAL HEALTH INSTITUTE
Certification status
Terminated Voluntary: merger or closure, Jul 1, 1992
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 3, 1992
Beds
20
Ownership / control type
State
Facility address
5908 Lyons View Pike
Knoxville, TN 37919

Hospital certification: CCN 444000

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LAKESHORE MENTAL HEALTH INSTITUTE
Certification status
Terminated Voluntary: merger or closure, Jun 30, 2012
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Jun 29, 2011
Beds
80
Ownership / control type
State
Facility address
5908 Lyons View Pike
Knoxville, TN 37919

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5908 Lyons View Pike
Knoxville, TN 37919
Phone (865) 583-8768

710 James Robertson Pkwy
Nashville, TN 37243

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1467538009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 LYONS VIEW PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37919",
            "telephone_number": "865-584-1561",
            "fax_number": "865-450-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 LYONS VIEW PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37919",
            "telephone_number": "865-584-1561",
            "fax_number": "865-450-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER - CEO",
        "authorized_official_telephone_number": "865-583-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TN",
            "license": "L2161051102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Mental Health Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.