Active NPI
Karis Community Health
- Dentist
- Cleveland, TN
National Provider Identifier
1730891839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- KARIS COMMUNITY HEALTH
- Practice address
- 254 Broad St SW
Cleveland, TN 37311-5929 - Phone
- (423) 457-8024
- NPI assigned
- Dec 20, 2022
- Last updated
- Dec 20, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Ohlsson
- Title
- Executive Director
- Phone
- (423) 457-8024
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NU | Primary |
Addresses
Primary practice location
254 Broad St SW
Cleveland, TN 37311-5929
Mailing address
254 Broad St SW
Cleveland, TN 37311-5929
Phone (423) 457-8024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q079332 | Medicaid | TN |
Other names 1
- KARIS COMMUNITY HEALTH
National Provider Directory
National Provider DirectoryLocations
254 Broad St SW
Cleveland, TN 37311
Phone (423) 457-8024
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Emergency Medicine Physician
- Cleveland, TN
- NPI 1720024037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671494400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671494400000",
"number": "1730891839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 BROAD ST SW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373115929",
"telephone_number": "423-457-8024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 BROAD ST SW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373115929",
"telephone_number": "423-457-8024"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KARIS COMMUNITY HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2022-12-20",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A",
"authorized_official_last_name": "OHLSSON",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "423-457-8024"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q079332",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "KARIS COMMUNITY HEALTH",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.