NPIMap

Organization Active NPI

State of Tennessee

  • Intellectual Disabilities Intermediate Care Facility
  • Greeneville, TN
National Provider Identifier
1871997163
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
I000000013242 Issued in TN
Legal business name
STATE OF TENNESSEE
Practice address
803 Redbud Dr
Greeneville, TN 37743-6141
Phone
(423) 525-5299
Fax
(423) 787-6465
NPI assigned
Oct 15, 2014
Last updated
Oct 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Authorized official

Name
Margi E Story
Title
Director
Phone
(423) 787-6481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X I000000013242 TN Primary

Addresses

Primary practice location

803 Redbud Dr
Greeneville, TN 37743-6141

Mailing address

PO Box 309
Greeneville, TN 37744-0309
Phone (423) 787-6500

Other names 1

  • East Tennessee Community Homes Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871997163. Details of each certification follow.

  • CCN 44G172 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 44G172

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EAST TENNESSEE COMMUNITY HOMES REDBUD
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 19, 2014
Last certification
Apr 16, 2025
Beds
4
Ownership / control type
State
Facility address
803 Redbud Drive
Greeneville, TN 37743

National Provider Directory

National Provider Directory
Tax ID family
Kingsport Health Center202 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

Locations

803 Redbud Dr
Greeneville, TN 37743
Phone (423) 525-5299

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1871997163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377440309",
            "telephone_number": "423-787-6500",
            "fax_number": "423-787-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 REDBUD DR",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377436141",
            "telephone_number": "423-525-5299",
            "fax_number": "423-787-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "STORY",
        "authorized_official_first_name": "MARGI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "423-787-6481"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TN",
            "license": "I000000013242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Tennessee Community Homes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.