NPIMap

Organization Active NPI

State of Tennessee

Doing business as Upper Cumberland Regional Clinic

  • Public Health or Welfare Agency
  • Cookeville, TN
National Provider Identifier
1598817017
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF TENNESSEE
Doing business as
Upper Cumberland Regional Clinic
Practice address
1100 England Drive
Cookeville, TN 38501-0924
Phone
(931) 520-4201
Fax
(931) 520-3871
NPI assigned
Jan 17, 2007
Last updated
Jun 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Tammy Stewart
Title
Cfo
Phone
(931) 520-4203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1100 England Drive
Cookeville, TN 38501-0924

Mailing address

1100 England Drive
Cookeville, TN 38501-0924
Phone (931) 520-4201

Other identifiers 1

IdentifierTypeStateIssuer
444-7818MedicaidTN

Other names 1

  • Upper Cumberland Regional Clinic 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

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
Tax ID family
Loudon County Health de202 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

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1598817017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ENGLAND DRIVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010924",
            "telephone_number": "931-520-4201",
            "fax_number": "931-520-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ENGLAND DRIVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010924",
            "telephone_number": "931-520-4201",
            "fax_number": "931-520-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "931-520-4203"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444-7818",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Cumberland Regional Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.