NPIMap

Organization Active NPI

Copper Basin Community Hospital Inc

Doing business as Copper Basin Medical Center

  • Critical Access Hospital
  • Copperhill, TN
National Provider Identifier
1750363115
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0000000094 Issued in TN
Legal business name
COPPER BASIN COMMUNITY HOSPITAL INC
Doing business as
Copper Basin Medical Center
Practice address
144 Medical Center Drive
Copperhill, TN 37317
Phone
(423) 496-5511
Fax
(423) 496-9311
NPI assigned
Nov 18, 2005
Last updated
May 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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

Authorized official

Name
Daniel C Johnson
Title
Ceo
Phone
(423) 496-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0000000094 TN Primary

Addresses

Primary practice location

144 Medical Center Drive
Copperhill, TN 37317

Mailing address

PO Box 990
Copperhill, TN 37317-0990
Phone (423) 496-5511

Other identifiers 3

IdentifierTypeStateIssuer
000000481AMedicaidGA
4400041MedicaidNC
0440041MedicaidTN

Other names 1

  • Copper Basin Medical Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495152000000",
    "number": "1750363115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "COPPERHILL",
            "state": "TN",
            "postal_code": "373170990",
            "telephone_number": "423-496-5511",
            "fax_number": "423-496-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MEDICAL CENTER DRIVE",
            "city": "COPPERHILL",
            "state": "TN",
            "postal_code": "37317",
            "telephone_number": "423-496-5511",
            "fax_number": "423-496-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER BASIN COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2017-05-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-496-5511"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TN",
            "license": "0000000094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000481A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4400041",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440041",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Basin Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Copperhill, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; 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.