Jellico Healthcare Associates LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

JELLICO HEALTHCARE ASSOCIATES LLC

Practice address

188 Hospital LN
Jellico, TN 37762-4400

Phone

(423) 784-7252

NPI assigned

Nov 15, 2016

Last updated

Nov 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kim Dowell

Title

Ceo

Phone

(423) 784-7252

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1497297949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624400",
            "telephone_number": "423-784-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624400",
            "telephone_number": "423-784-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JELLICO HEALTHCARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "DOWELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-784-7252",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jellico Community Hospital LLC
• Jellico Community Hospital, Inc (Jellico Community Hospital Wound Care Center)
• Jellico Community Hospital, Inc
• Jellico Drug Store Inc
• Jellico Emergency Physicians Medical Group PC
• Jellico Medical Center, Inc.
• Jellico Regional Hospital, LLC
• Jellico Regional Hospital, LLC
• Jellico Regional Hospital, LLC
• Jellico Regional Hospital, LLC (JRH Medical Group)

• Emergency Medicine Physician in Jellico, TN
• Providers in Jellico, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.