NPIMap

Organization Active NPI

Vanderbilt Coffee Hospital, LLC

Doing business as Vanderbilt Tullahoma-Harton Hospital

  • General Acute Care Hospital
  • Tullahoma, TN
National Provider Identifier
1831798719
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
VANDERBILT COFFEE HOSPITAL, LLC
Doing business as
Vanderbilt Tullahoma-Harton Hospital
Practice address
1801 N Jackson St
Tullahoma, TN 37388-8259
Phone
(931) 393-3000
NPI assigned
Oct 21, 2020
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Angela L Simmons
Title
VP - Finance
Phone
(615) 936-8875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

1801 N Jackson St
Tullahoma, TN 37388-8259

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other names 1

  • Vanderbilt Tullahoma-Harton Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201223000531 TN Part A Provider - Hospital 1254743867 Practice locations: Tullahoma, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831798719. Details of each certification follow.

Hospital certification: CCN 440144

Legal name
VANDERBILT COFFEE HOSPITAL LLC
Doing business as
VANDERBILT TULLAHOMA-HARTON HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 3, 1967
Last certification
Sep 28, 2010
Beds
135
Ownership / control type
Other
Most recent change of ownership
Nov 1, 2003 (1 total)
Organization structure
LLCNon-profit
Enrollment address
1750 Cedar LN
Ste 300
Tullahoma, TN 37388-4762
Other Hospital Practice Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Vanderbilt Tullahoma-Harton HospitalCCN 440144 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Vanderbilt Coffee Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1330 Cedar Ln
Ste 200
Tullahoma, TN 37388
Phone (931) 455-1092

1805 N Jackson St
Ste 4
Tullahoma, TN 37388
Phone (931) 393-7964

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John R Ingram Individual Corporate DirectorBoard Member Jul 1, 2022
Cecelia Moore Individual Corporate OfficerTreasurer Oct 9, 2020
Gail Carr Williams Individual Corporate DirectorBoard Member Jul 1, 2023
John Frederick Stein Individual Corporate DirectorGoverning Board Member Oct 9, 2020
Angela Simmons Individual Corporate Director Aug 1, 2021
Daniel Diermeier Individual Corporate DirectorGoverning Board Member Oct 9, 2020
Edith Carell Johnson Individual Corporate DirectorGoverning Board Member Oct 9, 2020
Richard Ellis Individual Contracted Managing EmployeePresident Jan 1, 2021
Makeba Williams Individual Corporate DirectorBoard Member Jul 1, 2022
Jane Freedman Individual W-2 Managing EmployeeChief Health System Officer Jul 1, 2025
Colin Reed Individual Corporate DirectorBoard Member Jul 1, 2023
Vanderbilt University Medical Center Organization, Nashville, TN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 9, 2020 100%
Operational/Managerial Control Jan 1, 2021
Lucinda M Baier Individual Corporate DirectorBoard Member Jul 1, 2022
Sara Finley Individual Corporate DirectorBoard Member Jan 1, 2022
Raymond D Mefford Individual Corporate OfficerSecretary/General Counsel Jul 1, 2024
Jeffrey Balser Individual Corporate DirectorGoverning Board Member Oct 9, 2020

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 397

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 397

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1831798719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888259",
            "telephone_number": "931-393-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDERBILT COFFEE HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP - FINANCE",
        "authorized_official_telephone_number": "615-936-8875"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Vanderbilt Tullahoma-Harton Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.