NPIMap

Organization Active NPI

State of Tennessee

  • Public Health or Welfare Agency
  • Wartburg, TN
National Provider Identifier
1679611404
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF TENNESSEE
Practice address
1103 Knoxville Highway
Wartburg, TN 37887
Phone
(423) 346-6272
Fax
(423) 346-2349
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Authorized official

Name
Marianne F Sharp
Title
Regional Accountant
Phone
(865) 549-5266

Specialties & licenses 1

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

Addresses

Primary practice location

1103 Knoxville Highway
Wartburg, TN 37887

Mailing address

PO Box 59019
Knoxville, TN 37950-9019
Phone (865) 549-5266

Other identifiers 2

IdentifierTypeStateIssuer
4447827MedicaidTN
157575OtherTNBLUECROSS BLUESHIELD TN

Other names 1

  • Morgan 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
O20041013001259 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5698687077 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Trousdale County Health202 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

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1679611404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59019",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379509019",
            "telephone_number": "865-549-5266",
            "fax_number": "865-594-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KNOXVILLE HIGHWAY",
            "city": "WARTBURG",
            "state": "TN",
            "postal_code": "37887",
            "telephone_number": "423-346-6272",
            "fax_number": "423-346-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "REGIONAL ACCOUNTANT",
        "authorized_official_telephone_number": "865-549-5266"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4447827",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD TN",
            "identifier": "157575",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morgan County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wartburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.