NPIMap

Organization Active NPI

Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elizabethton, TN
National Provider Identifier
1962564435
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
L-214-076-1406 Issued in TN
Legal business name
FRONTIER HEALTH
Practice address
426 E G St
Elizabethton, TN 37643-3224
Phone
(423) 547-5950
Fax
(423) 547-5953
NPI assigned
Dec 14, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Kristie Hammonds, PHD
Title
President and Ceo
Phone
(423) 467-3600

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
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…

National Provider Directory

National Provider Directory
Tax ID family
Lee County Integrated Care (62 organizations share this tax ID)

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X L-214-076-1406 TN
Community/Behavioral Health Agency 251S00000X L-214-076-1406 TN
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X L-214-076-1406 TN Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 363 TN

Addresses

NPPES NPI Registry

Primary practice location

426 E G St
Elizabethton, TN 37643-3224

Mailing address

PO Box 9054
Gray, TN 37615-9054
Phone (423) 467-3600

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
SAME AS MEDICARE #SMedicaidTN
49-4912-9MedicaidVA

Other names 1

NPPES NPI Registry
  • Charlotte Taylor Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 10, 2020.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1962564435",
    "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": "426 E G ST",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376433224",
            "telephone_number": "423-547-5950",
            "fax_number": "423-547-5953"
        }
    ],
    "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.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "TN",
            "license": "L-214-076-1406",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "L-214-076-1406",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TN",
            "license": "L-214-076-1406",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAME AS MEDICARE #S",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49-4912-9",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte Taylor Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charlotte Taylor Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethton, TN

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.

Verify at the official NPI Registry.