Wyndridge Health Systems

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0000000312 Issued in TN

Legal business name

WYNDRIDGE HEALTH SYSTEMS

Practice address

456 Wayne Avenue
Crossville, TN 38555

Phone

(931) 484-6129

Fax

(931) 484-2685

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary E Cochran

Title

Administrator

Phone

(931) 484-6129

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1932298700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVENUE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "38555",
            "telephone_number": "931-484-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 WAYNE AVENUE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "38555",
            "telephone_number": "931-484-6129",
            "fax_number": "931-484-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDRIDGE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-484-6129",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454116",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4011143",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Blaire Worley
• Brooke K Wright, CPNP
• Larry Shane Wyatt, LPC
• Madeline Wyatt, PT
• Mary Brooke Tackett Wyatt, PA
• Wyndridge TN Opco LLC
• Ashley Elizabeth Young, RN
• Brant R Young, PHARMD
• William M. Young, M.D..
• Zander Dentistry PLLC

• Durable Medical Equipment & Medical Supplies in Crossville, TN
• Providers in Crossville, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.