JLC Beechtree Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

JLC BEECHTREE INC

Practice address

240 Hospital LN
Jellico, TN 37762-4401

Phone

(423) 784-6626

Fax

(423) 784-6802

NPI assigned

May 1, 2009

Organization subpart

No

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

Authorized official

Name

Joe Brown

Title

President

Phone

(423) 784-6626

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1972747152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 ROSE ST",
            "address_2": "P.O. BOX 300",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622235",
            "telephone_number": "423-784-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL LN",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624401",
            "telephone_number": "423-784-6626",
            "fax_number": "423-784-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLC BEECHTREE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-784-6626"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jellico Regional Hospital, LLC
• Jellico Regional Hospital, LLC
• Jellico Surgery Center, LLC
• Jellico TN Opco LLC
• Jellico Wellness and Convenient Care Clinic, LLC
• Kabir Clinic LLC
• Mohammed Humayun Kabir, MD
• Suzanne Musick Kitts, PHARMD
• Terrence Wesley Leveck, MD
• Frederick Warren Martin, O.D.

• Skilled Nursing Facility in Jellico, TN
• Providers in Jellico, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.