Coffee County Hospital Group Inc

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

License

000000000019 Issued in TN

Legal business name

COFFEE COUNTY HOSPITAL GROUP INC

Doing business as

Medical Center of Manchester

Practice address

481 Interstate Dr
Manchester, TN 37355-3108

Phone

(931) 728-6354

Fax

(931) 728-5420

NPI assigned

May 1, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert J Couch

Title

Chief Executive Officer

Phone

(931) 728-6354

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDICAL CENTER OF MANCHESTER Doing business as

Practitioners 3

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.

• Bill B Hollins, DO

  • Internal Medicine Physician
  • Tullahoma, TN
  • NPI 1831296359
  NPD (past)
• Isaac H Stovall, M D

  • Emergency Medical Services (Emergency Medicine) Physician
  • Manchester, TN
  • NPI 1356356281
  NPD (past)
• Roland Ray Stroud Jr., MD

  • Family Medicine Physician
  • Tullahoma, TN
  • NPI 1598720948
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972724722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1409",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373494409",
            "telephone_number": "931-728-6354",
            "fax_number": "931-728-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 INTERSTATE DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553108",
            "telephone_number": "931-728-6354",
            "fax_number": "931-728-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE COUNTY HOSPITAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "931-728-6354"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TN",
            "license": "000000000019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44Z308",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL CENTER OF MANCHESTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Bailey Clay, PA-C
• CLC of Manchester, LLC (Manchester Community Living Center)
• Coffee Associates a Medical Management Organization, LLC (Rapha Centre)
• Coffee County Board of Education (Coffee County Schools)
• Coffee County Drug Court
• Coffee County Hospital Group, Inc
• Coffee County Physician Group PC
• Coffee Medical Group LLC (Unity Medical Center)
• Coffee Medical Group LLC (Manchester Rural Health Clinic)
• Coffee Medical Group LLC (United Regional Medical Center Nursing Home)

• Medicare Defined Swing Bed Hospital Unit in Manchester, TN
• Providers in Manchester, TN by specialty
• Medicare Defined Swing Bed Hospital Unit in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.