NPIMap

Organization Active NPI

Takoma Regional Hospital, Inc.

Doing business as Ballad Health Medical Associates

  • Pediatrics Physician
  • Greeneville, TN
National Provider Identifier
1861857567
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
TAKOMA REGIONAL HOSPITAL, INC.
Doing business as
Ballad Health Medical Associates
Kids First Pediatrics of NE TN
Practice address
5000 Monarch PT
Greeneville, TN 37745-4275
Phone
(423) 798-6630
NPI assigned
Dec 22, 2015
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
TAKOMA REGIONAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Gregory Lee Wilgocki
Title
VP Reimbursement
Phone
(423) 431-5794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

5000 Monarch PT
Greeneville, TN 37745-4275

Mailing address

105 W Stone Dr Ste 6a
Kingsport, TN 37660-3256
Phone (423) 408-7220

Other names 2

  • Ballad Health Medical Associates Doing business as
  • Kids First Pediatrics of NE TN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Takoma Regional Hospital Dba Takoma Medical Associates11 organizations share this tax ID, including this one
Part of
Takoma Regional Hospital Dba Takoma Medical Associates

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1861857567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR STE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603256",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MONARCH PT",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454275",
            "telephone_number": "423-798-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKOMA REGIONAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAKOMA REGIONAL HOSPITAL, INC.",
        "enumeration_date": "2015-12-22",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "WILGOCKI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "423-431-5794"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballad Health Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kids First Pediatrics of NE TN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.