Omni Community Health, Inc.
Organization Active NPI Community/Behavioral Health Agency · Knoxville, TN
NPI 1881024172 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1881024172
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- OMNI COMMUNITY HEALTH, INC.
- Practice address
- 4709 Papermill Dr Ste 100
Knoxville, TN 37909-1928 - Phone
- (865) 525-0391
- Fax
- (865) 525-0393
- NPI assigned
- Nov 22, 2013
- Organization subpart
- No
Authorized official
- Name
- Christopher Moynihan, LCSW
- Title
- President of Behavioral Health
- Phone
- (629) 256-0597
Corporate family (same tax ID) 10
Member organizations 1
Practitioners 102
-
Cindy Brown, APRN
-
Hannah Elizabeth Cassetty, PMHNP
-
Donna L Humbert, LICENSED CLINICAL SO
-
Katie Lauren Lindsay, LCSW
-
Aubrey Moss, PMHNP
-
Austin Allen Rich, APRN
-
Travis Allen Rich, APRN
-
Jacqueline Monique Terry, PMHNP
-
Vickie Dian Brown, PMHNP-BC
-
Lora Ann Deckard-Smart, APRN
-
Cynthia L Harmon, LCSW
-
Myrna K Kemp, L.P.C.
-
Katherine King, PMHNP-BC
-
Johnna Marie Kitts, M.ED.
-
Kelley Rieder Klungland, LPC-MHSP
-
Leigh Ann Pray, LMFT
-
Haley Weathers Stovall, PMHNP
-
Ayse Boswell Wise, PMHNP, WHNP, RN-C
-
Corinne Margaret Powell, MSN,RN,PMHNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2215826 | Omni Community Health - Louisville | Certificate of waiver | Mar 7, 2027 |
| 44D2217759 | Omni Community Health - Chattanooga | Certificate of waiver | Mar 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160727001569 | TN | Part B Supplier - Clinic/Group Practice | 5799078804 |
Receives reassigned benefits from 26 practitioners Practice locations: Oneida, TN; Murfreesboro, TN; Memphis, TN; Lebanon, TN; Goodlettsville, TN; Lawrenceburg, TN; La Follette, TN; Knoxville, TN… |
| O20190411001441 | KY | Part B Supplier - Clinic/Group Practice | 5799078804 |
Receives reassigned benefits from 2 practitioners Practice locations: Lexington, KY; Louisville, KY |
National Provider Directory
- Tax ID family
- Omni Community Health Inc
Locations
1240 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-8112
921 Beasley St
Ste 145
Lexington, KY 40509
Phone (502) 309-4510
2906 Eastpoint Pkwy
Louisville, KY 40223
Phone (502) 822-7679
704 W Madison Ave
Athens, TN 37303
Phone (423) 746-0163
404 S White St
Athens, TN 37303
Phone (423) 405-6038
1635 Chestnut St
Chattanooga, TN 37408
Phone (423) 207-4712
1401 Williams St
Ste 210
Chattanooga, TN 37408
Phone (423) 207-4712
2600 Executive Park NW
Cleveland, TN 37312
Phone (423) 458-4122
1365 Maley Hollow Rd
Dayton, TN 37321
Phone (314) 503-7015
2001 Mallory Ln
Ste 200
Franklin, TN 37067
Phone (615) 224-1590
615 W Main St
Ste 108
Greeneville, TN 37743
2700 S Roan St
Ste 425
Johnson City, TN 37601
Phone (423) 212-3853
4709 Papermill Dr
Ste 100
Knoxville, TN 37909
4709 Papermill Dr
Ste 202
Knoxville, TN 37909
Phone (865) 522-2881
2221 Jacksboro Pike
Ste C6
La Follette, TN 37766
256 S Bank St
Oneida, TN 37841
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Clinical Social Worker |
1041C0700X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X |
Addresses
Primary practice location
4709 Papermill Dr Ste 100
Knoxville, TN 37909-1928
Mailing address
301 S Perimeter Park Dr Ste 210
Nashville, TN 37211-4128
Phone (877) 258-8795
Other practice location 1
2906 Eastpoint Pkwy
Louisville, KY 40223-4186
Phone (502) 822-7679
Other practice location 2
1401 Williams St Ste 210
Chattanooga, TN 37408-1190
Phone (865) 525-0391
Other practice location 3
301 S Perimeter Park Dr
Suite 210
Nashville, TN 37211-4143
Phone (877) 258-8795
Other practice location 4
1055 National Mine Rd
Madisonville, KY 42431-8913
Phone (270) 825-1698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100055600 | Medicaid | KY | |
| Q004198 | Medicaid | TN | |
| 7100527730 | Medicaid | KY |
Other providers in Knoxville, TN
- Monica Olson
- Peggy L. Olson
- Zion Isaiah Olum
- Omega Pain Management, PC
- Omni Community Health
- Omni Functional Medicine, P.C.
- On Call Companion Care
- Ondemand Medical Group PLLC
- One to One Health PLLC
- Michael Glenn Oneil
All providers in Knoxville, TN · Community/Behavioral Health Agency in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.