NPIMap

Organization Active NPI

State of Tennessee

Doing business as Gibson County Health Department Milan Clinic

  • Public Health or Welfare Agency
  • Milan, TN
National Provider Identifier
1831249093
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STATE OF TENNESSEE
Doing business as
Gibson County Health Department Milan Clinic
Practice address
6501 Telecom Drive
Milan, TN 38358
Phone
(731) 686-9240
Fax
(731) 686-0962
NPI assigned
Jan 11, 2007
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mrs. Marilyn Barnes
Title
Regional Director
Phone
(731) 421-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

6501 Telecom Drive
Milan, TN 38358

Mailing address

PO 698
6501 Telecom Drive
Milan, TN 38358
Phone (731) 686-9240

Other identifiers 1

IdentifierTypeStateIssuer
4448183MedicaidTN

Other names 1

  • Gibson County Health Department Milan Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001259 TN Part B Supplier - Mass Immunization (Roster Biller Only) 5698687077 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Greene Valley Developmental Center Pharmacy202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1831249093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO 698",
            "address_2": "6501 TELECOM DRIVE",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "38358",
            "telephone_number": "731-686-9240",
            "fax_number": "731-686-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 TELECOM DRIVE",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "38358",
            "telephone_number": "731-686-9240",
            "fax_number": "731-686-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "731-421-6700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448183",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson County Health Department Milan Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milan, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.