NPIMap

Organization Active NPI

Parkwest Medical Center

  • Psychiatric Hospital Unit
  • Knoxville, TN
National Provider Identifier
1851369243
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0000000042 Issued in TN
Legal business name
PARKWEST MEDICAL CENTER
Practice address
9352 Parkwest Blvd
Knoxville, TN 37923
Phone
(865) 374-3000
NPI assigned
Mar 10, 2006
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Kevin D Brown
Title
VP, Patient Account Services
Phone
(865) 374-3090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0000000042 TN Primary

Addresses

Primary practice location

9352 Parkwest Blvd
Knoxville, TN 37923

Mailing address

PO Box 440436
Nashville, TN 37244-0436
Phone (865) 374-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PeninsulaBehavioralHealth@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429000423 TN Part B Supplier - Clinic/Group Practice 8527965417 Receives reassigned benefits from 103 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Louisville, TN; Sevierville, TN; Lenoir City, TN; Knoxville, TN; Alcoa, TN
O20110404000753 TN Part A Provider - Hospital 8527965417 Practice locations: Knoxville, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851369243. Details of each certification follow.

Hospital certification: CCN 44S173

Legal name
PARKWEST MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
May 11, 1990 in TN
Enrollment address
9352 Park West Blvd
Knoxville, TN 37923-4325
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: peninsulabehavioralhealth@covenanthealth.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Amy Delong Individual Corporate OfficerVice President/Controller Mar 4, 2024 100%
Covenant Health Organization, Knoxville, TN Non-profit 5% Or Greater Direct Ownership Interest Jul 22, 1996
Joseph Christopher Dolan Individual Corporate OfficerCovenant Health Cfo/Evp Jul 31, 2023 100%
Scott Hamilton Individual Corporate OfficerCfo Aug 27, 2007
W-2 Managing EmployeeCfo Aug 27, 2007
Devan Johnson Individual Corporate OfficerCao Jul 25, 2022
W-2 Managing EmployeeCao Jul 25, 2022
James Vandersteeg Individual Corporate OfficerCovenant Health Ceo/President Apr 1, 2016 100%

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1851369243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440436",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440436",
            "telephone_number": "865-374-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 PARKWEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37923",
            "telephone_number": "865-374-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWEST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP, PATIENT ACCOUNT SERVICES",
        "authorized_official_telephone_number": "865-374-3090"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "TN",
            "license": "0000000042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PeninsulaBehavioralHealth@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9352 Parkwest Blvd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.