Frontier Health
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Gray, TN
NPI 1720147408 · NPPES record last updated Apr 8, 2025
Key facts
- NPI
- 1720147408
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- FRONTIER HEALTH
- Practice address
- 1167 Spratlin Park Dr
Gray, TN 37615-9054 - Phone
- (423) 467-3600
- Fax
- (423) 467-3644
- NPI assigned
- Dec 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Kristie S Hammonds
- Title
- President and Ceo
- Phone
- (423) 467-3600
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 24
Practitioners 175
-
Felecia Gail Abdelfattah, APRN BC
-
Benton W Ashe, LCSW
-
Richard Zachary Barnett, APRN
-
Jessica Barry, LCSW
-
Anna Bogart, LPC
-
Jacqlyne Weber Bowman, PMHNP-BC
-
David E Brown, LPC/ MHSP
-
David L Brown, LPC MHSP
-
Erica R Broyles, LCSW
-
Ivy D Buerkle, MSW
-
Tricia Cannon, PMHNP-BC
-
Alicia N Carter, LPC, MHSP
-
Dorothy Sue Chapman, FNP-BC
-
Kristi Cook, FNP
-
Margaret L Cress, LMPT
-
Christy R. Crick, MA, LMFT
-
Shaylie Davis, APRN
-
Tiffani M Dotson, MSN, PMHNP-BC
-
Alison M Dyer, LPC/ MHSP
-
Kaitlynn Earls, PMHNP-BC
-
Kennedy L Eldridge, DNP, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040109000560 | TN | Part B Supplier - Clinic/Group Practice | 2860302320 |
Receives reassigned benefits from 124 practitioners 14 other NPIs on this enrollment Practice locations: Bristol, TN; Sneedville, TN; Rogersville, TN; Mountain City, TN; Kingsport, TN; Johnson City, TN; Greeneville, TN; Gray, TN… |
| O20040206000424 | VA | Part B Supplier - Clinic/Group Practice | 2860302320 |
Receives reassigned benefits from 41 practitioners Practice locations: Big Stone Gap, VA; Weber City, VA; Pennington Gap, VA; Duffield, VA; Jonesville, VA |
National Provider Directory
- Tax ID family
- Lee County Integrated Care
Locations
26 Midway St
Bristol, TN 37620
Phone (423) 989-4500
401 Holston Dr
Greeneville, TN 37743
Phone (423) 639-1104
430 Industrial Dr
Pennington Gap, VA 24277
Phone (540) 546-3591
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
1167 Spratlin Park Dr
Gray, TN 37615-9054
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3700
Other providers in Gray, TN
- Jaime Lea Ferguson
- Kara Ferry
- Mary Frances Filonuk
- Foundation Health Services, PLLC
- Frontier Health
- Leigh A Furman
- Genesis Family Healthcare PLLC
- Joshua Gibson
- Brandy Goble
- Bryon K Grant
All providers in Gray, TN · Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.