St. Mary'S Medical Center of Campbell County, Inc.

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

ST. MARY'S MEDICAL CENTER OF CAMPBELL COUNTY, INC.

Practice address

200 Torrey Rd
La Follette, TN 37766-2728

Phone

(423) 907-1379

Fax

(423) 907-1189

NPI assigned

Nov 22, 2006

Organization subpart

Yes

Parent organization

MERCY HEALTH PARTNERS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Angel David Jimenez

Title

President & Ceo

Phone

(865) 545-7558

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Lafollette Comm Hospital2 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.

• Lafollette Comm Hospital

  • General Acute Care Hospital
  • La Follette, TN
  • NPI 1891986162
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harjeet Narula, M.D.

  • Internal Medicine Physician
  • Jacksboro, TN
  • NPI 1811928799
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1689749749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662768",
            "telephone_number": "423-907-1200",
            "fax_number": "423-907-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TORREY RD",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662728",
            "telephone_number": "423-907-1379",
            "fax_number": "423-907-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S MEDICAL CENTER OF CAMPBELL COUNTY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH PARTNERS, INC.",
        "enumeration_date": "2006-11-22",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "865-545-7558",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452065",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sibley, FNP
• Mary R. Silcox, RNC
• Melissa M Smith, NP
• Brian Donald Sneck, DO
• Ann Raewyn Snodderly, PHARM D
• Barry A Stewart, MD
• Matthew D Stimson, CPED, CPOA, CFO
• Emily S Stiner, SP
• Janis K Stone
• Jason R Stooksbury, PT

• Nursing Facility Supplies (DME) in La Follette, TN
• Providers in La Follette, TN by specialty
• Nursing Facility Supplies (DME) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.