Active NPI
Frontier Health
Doing business as Church Street Pavilion
- Community/Behavioral Health Agency
- Greeneville, TN
National Provider Identifier
1881756161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- L214-076-1407
- Legal business name
- FRONTIER HEALTH
- Doing business as
- Church Street Pavilion
- Practice address
- 616 E Church St
Suite a
Greeneville, TN 37745-5084 - Phone
- (423) 639-3213
- Fax
- (423) 639-4692
- NPI assigned
- Dec 14, 2006
- Last updated
- Jan 10, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kristie Hammonds
- Title
- President and Ceo
- Phone
- (423) 467-3600
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | L-214-076-1407 | TN | |
| Adult Mental Health Clinic/Center | 261QM0850X | L-214-076-1407 | TN | |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 369 | TN | |
| Community/Behavioral Health Agency | 251S00000X | L214-076-1407 | TN | Primary |
Addresses
Primary practice location
616 E Church St
Suite a
Greeneville, TN 37745-5084
Mailing address
PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49-4919-6 | Medicaid | VA | |
| SAME AS MEDICARE #S | Medicaid | TN |
Other names 1
- Church Street Pavilion
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040109000560 | TN | Part B Supplier - Clinic/Group Practice | 2860302320 |
Receives reassigned benefits from 124 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bristol, TN; Sneedville, TN; Rogersville, TN; Mountain City, TN; Kingsport, TN; Johnson City, TN; Greeneville, TN; Gray, TN… |
Other NPIs on the same Medicare enrollment 14
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Hawkins County Mental Health Clinic
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rogersville, TN
- NPI 1043374564
O20040109000560
-
dba Hancock County Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sneedville, TN
- NPI 1053475558
O20040109000560
-
dba Fairview Associates of Johnson City
- Community/Behavioral Health Agency
- Johnson City, TN
- NPI 1134282551
O20040109000560
-
dba Bristol Regional Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bristol, TN
- NPI 1235291295
O20040109000560
-
dba Adventure Program
- Adolescent and Children Mental Health Clinic/Center
- Johnson City, TN
- NPI 1235298720
O20040109000560
-
dba Watauga Behavioral Health Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Johnson City, TN
- NPI 1386700383
O20040109000560
-
dba Johnson County Counseling Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mountain City, TN
- NPI 1396809851
O20040109000560
-
dba Erwin Mental Health Center
- Case Management Agency
- Erwin, TN
- NPI 1568524759
O20040109000560
-
dba Holston Children & Youth Services
- Adolescent and Children Mental Health Clinic/Center
- Kingsport, TN
- NPI 1578627006
O20040109000560
-
dba Holston Counseling Center
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1700940251
O20040109000560
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Gray, TN
- NPI 1720147408
O20040109000560
-
dba Nolachuckey -Holston Area Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greeneville, TN
- NPI 1760547004
O20040109000560
National Provider Directory
National Provider Directory- Tax ID family
- Lee County Integrated Care
Organizations with this tax ID in the same state 14
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Nolachuckey -Holston Area Mental Health Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greeneville, TN
- NPI 1760547004
-
dba Midland Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kingsport, TN
- NPI 1780556860
-
dba R. Grant Widner Group Home
- Mental Illness Community Based Residential Treatment Facility
- Bristol, TN
- NPI 1801018387
-
dba Virginia's Place
- Substance Abuse Rehabilitation Facility
- Johnson City, TN
- NPI 1811053341
-
dba Bristol Behavioral Health Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bristol, TN
- NPI 1811744477
-
dba Tennessee Community Support Services
- Adult Mental Health Clinic/Center
- Bristol, TN
- NPI 1821154352
-
dba Church Street Pavilion/Victory Center
- Rehabilitation Clinic/Center
- Greeneville, TN
- NPI 1841518867
-
dba Gibson Place 208
- Psychiatric Residential Treatment Facility
- Johnson City, TN
- NPI 1841635562
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Greeneville, TN
- NPI 1871733543
-
dba Frontier Health Crossing Point
- Community/Behavioral Health Agency
- Bluff City, TN
- NPI 1871947754
-
dba Frontier Health Link House
- Community/Behavioral Health Agency
- Kingsport, TN
- NPI 1871949123
Locations
616 E Church St
Ste A
Greeneville, TN 37745
Phone (423) 639-2316
Practitioners & affiliated clinicians
Practitioners 13
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.
-
- Professional Counselor
- Greeneville, TN
- NPI 1811900905
-
- Case Manager/Care Coordinator
- Greeneville, TN
- NPI 1760648083
-
- Registered Nurse
- Greeneville, TN
- NPI 1760709919
-
- Case Manager/Care Coordinator
- Knoxville, TN
- NPI 1003312893
-
- Case Manager/Care Coordinator
- Greeneville, TN
- NPI 1396939229
-
- Case Manager/Care Coordinator
- Greeneville, TN
- NPI 1972820165
-
- Licensed Practical Nurse
- Greeneville, TN
- NPI 1326216102
-
- Case Manager/Care Coordinator
- Greeneville, TN
- NPI 1700118940
-
- Case Manager/Care Coordinator
- Greeneville, TN
- NPI 1821351628
-
- Social Worker
- Greeneville, TN
- NPI 1811900947
-
- Registered Nurse
- Greeneville, TN
- NPI 1023345212
-
- Licensed Practical Nurse
- Greeneville, TN
- NPI 1619244308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578614400000",
"number": "1881756161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9054",
"city": "GRAY",
"state": "TN",
"postal_code": "376159054",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 E CHURCH ST",
"address_2": "SUITE A",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377455084",
"telephone_number": "423-639-3213",
"fax_number": "423-639-4692"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRONTIER HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-14",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A",
"authorized_official_last_name": "HAMMONDS",
"authorized_official_first_name": "KRISTIE",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "423-467-3600",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "TN",
"license": "L-214-076-1407",
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": "TN",
"license": "L-214-076-1407",
"primary": false
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "TN",
"license": "369",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "TN",
"license": "L214-076-1407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "49-4919-6",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAME AS MEDICARE #S",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Church Street Pavilion",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Church Street Pavilion",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greeneville, TN
- Laura Elizabeth Freshour, R.N.
- Susan Laird Fritz, M.S., CCC-SLP
- Frontier Health (Nolachuckey -Holston Area Mental Health Center)
- Frontier Health (Church Street Pavilion/Victory Center)
- Frontier Health
- Stephanie Ann Frost, DC
- James Jeffery Fuller, RRT
- Timothy Louis Fuller, DO
- Christina Rochelle Gaby, FNP
- Erin Colleen Gaby, MSOT, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.