NPIMap

Organization Active NPI

State of Tennessee

Doing business as Wilson County Health Department

  • Public Health or Welfare Agency
  • Lebanon, TN
National Provider Identifier
1609929389
Registry record updated Aug 28, 2012
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
Wilson County Health Department
Practice address
927 E Baddour Pkwy
Lebanon, TN 37087-3706
Phone
(615) 444-5325
Fax
(615) 444-2750
NPI assigned
Jan 18, 2007
Last updated
Aug 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

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

Addresses

Primary practice location

927 E Baddour Pkwy
Lebanon, TN 37087-3706

Mailing address

927 E Baddour Pkwy
Lebanon, TN 37087-3706
Phone (615) 444-5325

Other identifiers 1

IdentifierTypeStateIssuer
4448016MedicaidTN

Other names 1

  • Wilson County Health Department 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

Locations

927 E Baddour Pkwy
Lebanon, TN 37087
Phone (615) 444-5325

NPI Registry JSON

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": "1609929389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 E BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873706",
            "telephone_number": "615-444-5325",
            "fax_number": "615-444-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 E BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873706",
            "telephone_number": "615-444-5325",
            "fax_number": "615-444-2750"
        }
    ],
    "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": "4448016",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, TN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.