Active NPI
Frontier Health
Doing business as R. Grant Widner Group Home
- Mental Illness Community Based Residential Treatment Facility
- Bristol, TN
National Provider Identifier
1801018387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 20647
- Legal business name
- FRONTIER HEALTH
- Doing business as
- R. Grant Widner Group Home
- Practice address
- 4121 Old Jonesboro Rd
Bristol, TN 37620-5342 - Phone
- (423) 652-7378
- NPI assigned
- May 3, 2007
- Last updated
- Oct 5, 2018
- Organization subpart
- Yes
- Parent organization
- FRONTIER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Teresa M Kidd, PHD
- Title
- President/Ceo
- Phone
- (423) 467-3600
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 20647 | TN | Primary |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | L 324-076-1424 | TN | |
| Psychiatric Residential Treatment Facility | 323P00000X | L324-076-1424 | TN |
Addresses
Primary practice location
4121 Old Jonesboro Rd
Bristol, TN 37620-5342
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other names 1
- R. GRANT WIDNER GROUP HOME
National Provider Directory
National Provider Directory- Tax ID family
- Wise County Integrated Care
- Part of
- Wise County Integrated Care
Organizations with this tax ID in the same state 23
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Holston Children & Youth Services
- Adolescent and Children Mental Health Clinic/Center
- Kingsport, TN
- NPI 1578627006
-
dba Turning Point
- Community/Behavioral Health Agency
- Johnson City, TN
- NPI 1619529971
-
dba Holston Residence
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1669694220
-
- Mental Illness Community Based Residential Treatment Facility
- Gray, TN
- NPI 1699101618
-
dba Supportive Living - Bristol
- Community/Behavioral Health Agency
- Bristol, TN
- NPI 1699826735
-
dba Holston Counseling Center
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1700940251
-
dba Frontier Industries Kingsport
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Kingsport, TN
- NPI 1700941721
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Gray, TN
- NPI 1720147408
-
dba Nolachuckey -Holston Area Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greeneville, TN
- NPI 1760547004
-
dba Midland Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kingsport, TN
- NPI 1780556860
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Psychologist
- Greeneville, TN
- NPI 1386656403
-
- Other Technician
- Bristol, TN
- NPI 1801910815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1538697600000",
"number": "1801018387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9054",
"city": "GRAY",
"state": "TN",
"postal_code": "376159054",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 OLD JONESBORO RD",
"city": "BRISTOL",
"state": "TN",
"postal_code": "376205342",
"telephone_number": "423-652-7378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRONTIER HEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FRONTIER HEALTH",
"enumeration_date": "2007-05-03",
"last_updated": "2018-10-05",
"status": "A",
"authorized_official_last_name": "KIDD",
"authorized_official_first_name": "TERESA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "423-467-3600",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "TN",
"license": "20647",
"primary": true
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "TN",
"license": "L 324-076-1424",
"primary": false
},
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": "TN",
"license": "L324-076-1424",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "R. GRANT WIDNER GROUP HOME",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "R. GRANT WIDNER GROUP HOME",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bristol, TN
- Frontier Health (Adolescent Drug and Alcohol Recovery)
- Frontier Health (Fairmount Group Home)
- Frontier Health (Bristol Regional Counseling Center)
- Frontier Health
- Frontier Health (Supportive Living - Bristol)
- Frontier Health (Bristol Behavioral Health Services)
- Frontier Health (Tennessee Community Support Services)
- Frontier Health (Frontier Industries Bristol)
- Katy Fuqua Fuqua
- Paige Clifton Furrow, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.