NPIMap

Organization Active NPI

Shelbyville Hospital Company LLC

  • Rural Health Clinic/Center
  • Shelbyville, TN
National Provider Identifier
1548788458
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0000000002 Issued in TN
Legal business name
SHELBYVILLE HOSPITAL COMPANY LLC
Doing business as
Tennova Urgent Care-Shelbyville
Practice address
1612 N Main St Ste a
Shelbyville, TN 37160-2392
Phone
(931) 680-8910
Fax
(931) 685-4158
NPI assigned
Aug 31, 2017
Organization subpart
Yes
Parent organization
SHELBYVILLE HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Cheri Suzette Kane
Title
Vice President
Phone
(615) 465-7463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0000000002 TN Primary

Addresses

Primary practice location

1612 N Main St Ste a
Shelbyville, TN 37160-2392

Mailing address

1612 N Main St Ste a
Shelbyville, TN 37160-2392
Phone (931) 680-8910

Other names 1

  • Tennova Urgent Care-Shelbyville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Lynchburg Family Medicine

Locations

1612 N Main St
Ste A
Shelbyville, TN 37160
Phone (931) 680-8910

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2021 Change of OwnershipThis provider was the seller Vanderbilt Integrated Urgent CareCCN 443457, TN, NPI 1932708658

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548788458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 N MAIN ST STE A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602392",
            "telephone_number": "931-680-8910",
            "fax_number": "931-685-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 N MAIN ST STE A",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602392",
            "telephone_number": "931-680-8910",
            "fax_number": "931-685-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBYVILLE HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBYVILLE HOSPITAL COMPANY LLC",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_middle_name": "SUZETTE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-465-7463"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TN",
            "license": "0000000002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennova Urgent Care-Shelbyville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, TN

Sources for this page

Verify at the official NPI Registry.