NPIMap

Organization Active NPI

Takoma Regional Hospital Inc

Doing business as Ballad Health Medical Associates

  • General Acute Care Hospital
  • Greeneville, TN
National Provider Identifier
1699819003
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
TAKOMA REGIONAL HOSPITAL INC
Doing business as
Ballad Health Medical Associates
Greeneville Community Hospital
Practice address
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone
(423) 787-5000
Fax
(423) 787-5147
NPI assigned
Feb 18, 2007
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Shane Edwin Hilton
Title
Evp/Cfo
Phone
(423) 302-3467

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1420 Tusculum Blvd
Greeneville, TN 37745-4279

Mailing address

311 Princeton Rd Ste 1
Johnson City, TN 37601-2080
Phone (423) 787-5000

Other names 2

  • Ballad Health Medical Associates Doing business as
  • GREENEVILLE COMMUNITY HOSPITAL Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Takoma Regional Hospital Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070727000394 TN Part B Supplier - Clinic/Group Practice 8729189295 Receives reassigned benefits from 37 practitioners
Practice locations: Greeneville, TN; Kingsport, TN; Chuckey, TN
O20200106000867 TN Part A Provider - Hospital 8729189295 Practice locations: Greeneville, TN; Rogersville, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699819003. Details of each certification follow.

Hospital certification: CCN 440050

Legal name
TAKOMA REGIONAL HOSPITAL INC
Doing business as
GREENEVILLE COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 15, 2012
Beds
140
Ownership / control type
Private (not for profit)
Most recent change of ownership
May 1, 2007 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Sep 15, 2006 in TN
Enrollment address
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Greeneville Community HospitalCCN 440050 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Takoma Regional HospitalCCN 44T050
Ownership
Non-profit
Certified
Jul 1, 1999

This is a unit of this hospital with its own CMS Certification Number. Care Compare reports it separately, and it has no NPI of its own. How units are connected

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

350 Blountville Hwy
Ste 201
Bristol, TN 37620
Phone (423) 217-1337

401 Takoma Ave
Fl 2
Greeneville, TN 37743

401 Takoma Ave
Ste 1
Greeneville, TN 37743

438 E Vann Rd
Ste 200
Greeneville, TN 37743
Phone (423) 278-1704

438 E Vann Rd
Ste 301
Greeneville, TN 37743
Phone (423) 278-1650

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Shane Hilton Individual Corporate OfficerEvp/Cfo Apr 4, 2024
Corporate DirectorBoard Member Apr 4, 2024
Gregory Wilgocki Individual Corporate DirectorSVP Feb 1, 2018
W-2 Managing Employee Feb 1, 2018
Wellmont Health System Organization, Kingsport, TN Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Dec 8, 2016 100%
Ballad Health Organization, Johnson City, TN Corporation 5% Or Greater Indirect Ownership Interest Feb 1, 2018 100%
Marvin Eichorn Individual Corporate OfficerEvp/Cao Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Buford Deaton Individual Corporate OfficerEvp/Coo Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Alan Levine Individual Corporate OfficerCeo/President Feb 1, 2018
Corporate DirectorBoard Member Feb 1, 2018
Julie Bennett Individual Corporate OfficerEvp/Clo Feb 1, 2023
Corporate DirectorBoard Member Feb 1, 2023
Takoma Regional Hospital Inc Organization, Greeneville, TN Non-profit 5% Or Greater Direct Ownership Interest Sep 15, 2006 100%

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 40

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

View all 40

Practitioners & affiliated clinicians

Practitioners 50

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 50

Affiliated clinicians 371

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

View all 371

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1699819003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012080",
            "telephone_number": "423-787-5000",
            "fax_number": "423-787-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454279",
            "telephone_number": "423-787-5000",
            "fax_number": "423-787-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKOMA REGIONAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-18",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "HILTON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "423-302-3467"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://67.32.31.88:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1340.1",
            "affiliationName": "Takoma Regional Hospital Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "1.5, 1.6",
            "address_1": "1420 Tusculum Blvd",
            "city": "Greeneville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377454279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREENEVILLE COMMUNITY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.