Progressive Health of Jellico LLC

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

Legal business name

PROGRESSIVE HEALTH OF JELLICO LLC

Practice address

188 Hospital LN
Jellico, TN 37762-4400

Phone

(423) 455-0245

NPI assigned

Feb 20, 2024

Last updated

Mar 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Q Whitwell

Title

Ceo

Phone

(662) 701-9346

Specialties & licenses 2

Addresses

Tax ID family

Progressive Health of Jellico LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Progressive Health of Jellico LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Jellico, TN
  • NPI 1063279594
  NPD tax ID

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1669237319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624400",
            "telephone_number": "423-455-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624400",
            "telephone_number": "423-455-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HEALTH OF JELLICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "WHITWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-701-9346"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Sue Nantz, PHARMD
• North Campbell Community Hospital Inc
• North Campbell Community Hospital Inc
• Pine Mountain Emergency Physicians
• Progressive Health of Jellico LLC
• Kenneth J Reed, P.A.C.
• Sarah Roberts, PHARMD
• Crystal G Smiddy
• Matthew Christopher Sowards, PHARMD, MBA
• Springs of Life

• Critical Access Hospital in Jellico, TN
• Providers in Jellico, TN by specialty
• Critical Access Hospital in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.