NPIMap

Organization Active NPI

State of Tennessee

Doing business as Department of Intellectual and Developmental Disabilities

  • Home Health Agency
  • Greeneville, TN
National Provider Identifier
1467723155
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
STATE OF TENNESSEE
Doing business as
Department of Intellectual and Developmental Disabilities
Practice address
2107 Susong Rd
Greeneville, TN 37743-4944
Phone
(423) 787-0673
NPI assigned
Jan 26, 2012
Last updated
Jul 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
David Comm
Title
Director of Business Services
Phone
(629) 267-8103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary
Intellectual Disabilities Intermediate Care Facility 315P00000X I000000010134 TN

Addresses

Primary practice location

2107 Susong Rd
Greeneville, TN 37743-4944

Mailing address

315 Deaderick St FL 8
Nashville, TN 37238-3000

Other identifiers 1

IdentifierTypeStateIssuer
7447173MedicaidTN

Other names 1

  • Department of Intellectual and Developmental Disabilities Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maury Co Healt H Dept202 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

Locations

2107 Susong Rd
Greeneville, TN 37743
Phone (423) 787-0673

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1467723155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 DEADERICK ST FL 8",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372383000",
            "fax_number": "615-253-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 SUSONG RD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377434944",
            "telephone_number": "423-787-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "COMM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "629-267-8103"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TN",
            "license": "I000000010134",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Intellectual and Developmental Disabilities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.