NPIMap

Organization Active NPI

Rural Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dandridge, TN
National Provider Identifier
1871535583
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL MEDICAL SERVICES, INC.
Practice address
3222 Chestnut Hill School Rd
Dandridge, TN 37725-7238
Phone
(865) 509-6611
Fax
(865) 509-8811
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Mr. George Barton
Title
Ceo
Phone
(423) 613-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

3222 Chestnut Hill School Rd
Dandridge, TN 37725-7238

Mailing address

3222 Chestnut Hill School Rd
Dandridge, TN 37725-7238
Phone (865) 509-6611

Other identifiers 1

IdentifierTypeStateIssuer
0441855MedicaidTN

Other names 1

  • Chestnut Hill Center Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050914001081 TN Part B Supplier - Clinic/Group Practice 1456384080 Receives reassigned benefits from 24 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Pine, TN; Parrottsville, TN; Newport, TN; Jefferson City, TN; Hartford, TN; Dandridge, TN
O20071226000167 TN Part A Provider - Federally Qualified Health Center (FQHC) 1456384080 Practice locations: Dandridge, TN

Federally qualified health center certification: CCN 441855

Legal name
RURAL MEDICAL SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2001
Last certification
Dec 10, 2001
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1981 in TN
Enrollment address
3222 Chestnut Hill School Rd
Dandridge, TN 37725-7238

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0993080Rural Medical Services, Inc3222 Chestnut Hill School Road, Dandridge, TN 37725Provider-performed microscopyNov 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Rural Medical Services Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

3222 Chestnut Hill School Rd
Dandridge, TN 37725
Phone (865) 509-6611

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Travis Hall Individual Corporate DirectorBoard Member Jan 1, 2023
Derrick Woods Individual Corporate DirectorBoard Member Jan 1, 2022
Josh Hartsell Individual Corporate DirectorBoard Member Jan 1, 2022
Jamie Clark Individual Corporate DirectorBoard Member Apr 1, 2018
Sam Moscato Individual Corporate DirectorBoard Member Jan 1, 2021
Leslie J Childress Individual Corporate DirectorBoard Member Apr 1, 2018
Amy Bradshaw Individual Corporate DirectorInterim Ceo Aug 1, 2025
W-2 Managing EmployeeInterim Ceo Aug 1, 2025
Bonnie Ezell Individual Corporate DirectorBoard Member Apr 1, 2018
Crystal Chambers Individual Corporate DirectorBoard Member Jan 1, 2023

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1871535583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 CHESTNUT HILL SCHOOL RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377257238",
            "telephone_number": "865-509-6611",
            "fax_number": "865-509-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3222 CHESTNUT HILL SCHOOL RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377257238",
            "telephone_number": "865-509-6611",
            "fax_number": "865-509-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-613-3300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0441855",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Hill Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dandridge, TN

Sources for this page

Verify at the official NPI Registry.