Active NPI
Brakebill Nursing Home, Inc.
Doing business as Brakebill Nursing and Rehabilitation Center
- Nursing Facility/Intermediate Care Facility
- Knoxville, TN
National Provider Identifier
1942202171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 0000000141
- Legal business name
- BRAKEBILL NURSING HOME, INC.
- Doing business as
- Brakebill Nursing and Rehabilitation Center
- Practice address
- 5837 Lyons View Pike
Knoxville, TN 37919-6474 - Phone
- (865) 584-3902
- Fax
- (865) 584-2122
- NPI assigned
- Jun 1, 2005
- Last updated
- Aug 2, 2007
- Organization subpart
- Yes
- Parent organization
- BRAKEBILL NURSING HOME, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James Wilkerson, CPA
- Title
- Controller
- Phone
- (865) 584-3902
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0000000141 | TN | Primary |
Addresses
Primary practice location
5837 Lyons View Pike
Knoxville, TN 37919-6474
Mailing address
5837 Lyons View Pike
Knoxville, TN 37919-6474
Phone (865) 584-3902
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 313M00000X | Medicaid | TN | |
| 1000662 | Other | TN | BCBS |
Other names 1
- Brakebill Nursing and Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Brakebill Nursing Home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186012800000",
"number": "1942202171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5837 LYONS VIEW PIKE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379196474",
"telephone_number": "865-584-3902",
"fax_number": "865-584-2122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5837 LYONS VIEW PIKE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379196474",
"telephone_number": "865-584-3902",
"fax_number": "865-584-2122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRAKEBILL NURSING HOME, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRAKEBILL NURSING HOME, INC.",
"enumeration_date": "2005-06-01",
"last_updated": "2007-08-02",
"status": "A",
"authorized_official_last_name": "WILKERSON",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "865-584-3902",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "TN",
"license": "0000000141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "313M00000X",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1000662",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brakebill Nursing and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.