NPIMap

Organization Active NPI

Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
National Provider Identifier
1609860659
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0000000084 Issued in TN
Legal business name
FORT LOUDOUN MEDICAL CENTER
Practice address
550 Fort Loudoun Medical Center Dr
Lenoir City, TN 37772-5673
Phone
(865) 458-8222
NPI assigned
Sep 6, 2005
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
COVENANT HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Robert Boos
Title
SVP Revenue Cycle
Phone
(865) 374-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000000084 TN Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

550 Fort Loudoun Medical Center Dr
Lenoir City, TN 37772-5673

Mailing address

PO Box 440016
Nashville, TN 37244-0016
Phone (865) 374-3000

Other identifiers 1

IdentifierTypeStateIssuer
0440110MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address FortLoudounMedicalCenter@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031219000829 TN Part A Provider - Hospital 3476451063 Practice locations: Lenoir City, TN
O20050302000944 TN Part B Supplier - Clinic/Group Practice 3476451063 Receives reassigned benefits from 5 practitioners
Practice locations: Lenoir City, TN
O20250212001501 TN Part B Supplier - Intensive Cardiac Rehabilitation 3476451063 Practice locations: Lenoir City, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609860659. Details of each certification follow.

Hospital certification: CCN 440110

Legal name
FORT LOUDOUN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 15, 2026
Beds
50
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Nov 16, 1988 in TN
Enrollment address
550 Fort Loudoun Medical Center Dr
Lenoir City, TN 37772-5673
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Fort Loudoun Medical CenterCCN 440110 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0659207Fort Loudoun Medical Center550 Fort Loudoun Medical Center Drive, Lenoir City, TN 37772AccreditationNov 30, 2027

National Provider Directory

National Provider Directory

Locations

1420 Centerpoint Blvd
Bldg A
Knoxville, TN 37932

423 Medical Park Dr
Ste 300
Lenoir City, TN 37772
Phone (865) 271-6060

1127 Grove St
Loudon, TN 37774
Phone (865) 271-6060

Interoperability endpoints

  • Direct secure messaging: fortloudounmedicalcenter@covenanthealth.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amy Delong Individual Corporate OfficerVice President/Controller Mar 4, 2024 100%
Covenant Health Organization, Knoxville, TN 5% Or Greater Direct Ownership Interest Jun 24, 2004 100%
Joseph Christopher Dolan Individual Corporate OfficerCovenant Health Cfo/Evp Jul 31, 2023
Scott Hamilton Individual Corporate OfficerCfo Aug 26, 2013
W-2 Managing EmployeeCfo Aug 26, 2013
Connie Martin Individual Corporate OfficerCao Apr 1, 2022
W-2 Managing EmployeeCao Apr 1, 2022
Rick Carringer Individual Corporate OfficerVice President Jan 1, 2024 100%
James Vandersteeg Individual Corporate OfficerCovenant Health Ceo/President Apr 1, 2016 100%

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Practitioners 19

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 19

Affiliated clinicians 452

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 452

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1609860659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440016",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440016",
            "telephone_number": "865-374-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FORT LOUDOUN MEDICAL CENTER DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725673",
            "telephone_number": "865-458-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LOUDOUN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT HEALTH",
        "enumeration_date": "2005-09-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "BOOS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SVP REVENUE CYCLE",
        "authorized_official_telephone_number": "865-374-3000"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TN",
            "license": "0000000084",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440110",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FortLoudounMedicalCenter@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "550 Fort Loudoun Medical Center Dr",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377725673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

Verify at the official NPI Registry.