NPIMap

Takoma Regional Hospital Inc

Organization Active NPI General Acute Care Hospital · Greeneville, TN

NPI 1699819003 · NPPES record last updated Apr 22, 2025

Key facts

NPI
1699819003
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
TAKOMA REGIONAL HOSPITAL INC
Practice address
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone
(423) 787-5000
Fax
(423) 787-5147
NPI assigned
Feb 18, 2007
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 9

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

Member of 2

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

Facilities with the same owner 40

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

View all 40

Practitioners 50

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

View all 50

Affiliated clinicians 371

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

View all 371

Medicare Care Compare: Hospital

Listed as
Greeneville Community Hospital CCN 440050
Overall star rating
★★☆☆☆ 2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
Takoma Regional Hospital CCN 44T050
Ownership
Non-profit
Certified
Jul 1, 1999

Source: Medicare Care Compare. 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).

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN

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
Corporation · Non-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

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 Officer
Evp/Cfo		 Apr 4, 2024
Corporate Director
Board Member		 Apr 4, 2024
Gregory Wilgocki
Individual 		Corporate Director
SVP		 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 Officer
Evp/Cao		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Buford Deaton
Individual 		Corporate Officer
Evp/Coo		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Alan Levine
Individual 		Corporate Officer
Ceo/President		 Feb 1, 2018
Corporate Director
Board Member		 Feb 1, 2018
Julie Bennett
Individual 		Corporate Officer
Evp/Clo		 Feb 1, 2023
Corporate Director
Board Member		 Feb 1, 2023
Takoma Regional Hospital Inc
Organization · Greeneville, TN
Non-profit 		5% Or Greater Direct Ownership Interest Sep 15, 2006 100%

Medicare enrollment records

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

National Provider Directory

Locations

303 Takoma Ave
Greeneville, TN 37743
Phone (423) 636-0491

401 Takoma Ave
Fl 2
Greeneville, TN 37743

401 Takoma Ave
Ste 1
Greeneville, TN 37743

1021 Coolidge St
Ste 4
Greeneville, TN 37743
Phone (423) 237-6900

438 E Vann Rd
Greeneville, TN 37743
Phone (423) 278-1682

1021 Coolidge St
Greeneville, TN 37743
Phone (423) 636-0700

1406 Tusculum Blvd
Ste 2004
Greeneville, TN 37745
Phone (423) 783-5500

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
3774303OtherTNJOHN DEERE
100020449OtherTNPREFERRED HEALTH
4147074OtherTNBLUE CROSS

Other names

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

Electronic endpoints

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 22, 2025.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "3774303",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH",
            "identifier": "100020449",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4147074",
            "state": "TN"
        }
    ],
    "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

All providers in Greeneville, TN · General Acute Care Hospital in Tennessee

Sources for this page

Verify at the official NPI Registry.