State of Tennessee

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

STATE OF TENNESSEE

Doing business as

Hendersonville Health Department

Practice address

351 New Shackle Island Rd
Hendersonville, TN 37075-2300

Phone

(615) 824-0552

Fax

(615) 824-9771

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Annette Haley

Title

Regional Director

Phone

(615) 650-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hendersonville Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1518010339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 NEW SHACKLE ISLAND RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752300",
            "telephone_number": "615-824-0552",
            "fax_number": "615-824-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 NEW SHACKLE ISLAND RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752300",
            "telephone_number": "615-824-0552",
            "fax_number": "615-824-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "615-650-7000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hendersonville Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine McLean Stanfill, FNP
• Brodey Stanley
• Michael A. Stanley
• Blair Alexandra Stanton
• Jamesha Starnes
• Courtney Staton
• Staveoff Tennessee LLC
• Sarah Kathryn Steele, PSY.D.
• Jackson Steeley, PT, DPT
• Jill Steier, MD

• Public Health or Welfare Agency in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Public Health or Welfare Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.