EAST TENNESSEE STATE UNIVERSITY (NPI# 1215045976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215045976 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE STATE UNIVERSITY |
| Other Organization Name | HANCOCK COUNTY HIGH SCHOOL BASED HEALTH CENTER |
| Practice Address |
2700 Main Street Sneedville TN 37869-0723 |
| Mailing Address |
Po Box 70403 Johnson City TN 37614-1703 |
| Practice Telephone | 4237332819 |
| Practice Fax Number | 4237338509 |
| Mailing Telephone | (423) 439-4078 |
| Mailing Fax Number | 4234394060 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2017-09-22 |
| Authorized Official Name | DAVID D. COLLINS (CFO, VP FINANCE & ADMINISTRATION) |
| Authorized Official Telephone | 4234395884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3709292 | 05 |
| Other Name | Type Code |
|---|---|
| Hancock County High School Based Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275902884 | East Tennessee State University | Nurse Practitioner | 1000 N Roan St, Johnson City, TN 37601-4616 | 2015-09-24 |
| 1952785081 | East Tennessee State University | Nurse Practitioner | 3261 Tn 81, Jonesborough, TN 37659 | 2015-07-18 |
| 1982905576 | East Tennessee State University | Clinic/Center | 1134-1136 E. Main Street, Johnson City, TN 37601 | 2010-11-12 |
| 1851526826 | East Tennessee State University | Nurse Practitioner | 306 Forrest Dr, Jonesborough, TN 37659-1550 | 2009-05-20 |
| 1548422330 | East Tennessee State University | Audiologist | 837 Pardee St, Johnson City, TN 37601-5900 | 2008-07-02 |
| 1942474762 | East Tennessee State University | Speech-Language Pathologist | 300 Urbana Rd, Limestone, TN 37681-2824 | 2008-04-14 |
| 1093990608 | East Tennessee State University | Clinic/Center | 202 W Fairview Ave, Johnson City, TN 37604-5611 | 2008-01-02 |
| 1326142563 | East Tennessee State University | Nurse Practitioner | 391 Court Sq, Sneedville, TN 37869-0723 | 2006-09-08 |
| 1568570273 | East Tennessee State University | Nurse Practitioner | 365 Stout Drive, Nicks Hall Rm 160, Johnson City, TN 37614-6500 | 2006-08-25 |
| 1295779361 | East Tennessee State University | Clinic/Center | 1901 S Shady Street, Mountain City, TN 37683-2601 | 2006-06-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EAST TENNESSEE STATE UNIVERSITY | 2109 W Market St, Johnson City, TN 37604-6024 |
| Street Address |
2700 MAIN STREET |
| City | SNEEDVILLE |
| State | TN |
| Zip Code | 37869-0723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215225073 | Melinda Fleenor | Nurse Practitioner | 2700 Main Street, Sneedville, TN 37869-0723 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568905925 | Wellmont Health System | Clinic/Center | 1519 Main Street, Sneedville, TN 37869 | 2016-12-02 |
| 1881833192 | Truett Haze Pierce | Family Medicine | 215 Circle Drive, Sneedville, TN 37869 | 2009-02-10 |
| 1740491638 | Allison Lawson | Pharmacist | 1267 Main Street, Sneedville, TN 37869 | 2007-05-24 |
| 1558490482 | Detra Lynn Lewis | Pharmacist | 1260 West Main Street, Sneedville, TN 37869 | 2007-03-05 |
| 1306985981 | Sally June Morris | Registered Nurse | 178 Willow St., Sneedville, TN 37869 | 2007-02-06 |
| 1255470811 | Margaret Ruth Wilson | Registered Nurse | 178 Willow Street, Sneedville, TN 37869 | 2007-02-06 |
| 1073674933 | County of Hancock | Home Health | 1246 Main Street, Sneedville, TN 37869 | 2006-12-13 |
| 1881798569 | Jennifer Michelle Herron | Licensed Practical Nurse | 333 Campbell Dr, Sneedville, TN 37869 | 2006-09-12 |
| 1043314735 | Martha Jane Brooks | Social Worker | 333 Campbell Drive, Sneedville, TN 37869 | 2006-09-12 |
| 1194833251 | Ken B Smith | Pharmacist | 140 Church Street, Sneedville, TN 37869 | 2006-08-28 |
| Find all providers in zip 37869 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861492431 | Rural Health Services Consortium of Upper East Tennessee Inc | Clinic/Center | 300 River Rd, Sneedville, TN 37869-3806 | 2005-07-26 |
| 1669472460 | Rural Health Services Consortium of Upper East Tennessee Inc | Clinic/Center | 1861 Main St, Sneedville, TN 37869-3645 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525809 | Christ Community Health Services, Inc | Clinic/Center | 4350 Chuck Ave, Memphis, TN 38118-4076 | 2020-07-08 |
| 1730707621 | Christ Community Health Services, Inc. | Clinic/Center | 3206 Poplar Ave, Memphis, TN 38111-3502 | 2020-07-08 |
| 1003442112 | Christ Commuity Health Services Inc | Clinic/Center | 3360 S 3rd St, Memphis, TN 38109-2944 | 2020-03-20 |
| 1689160939 | Maury Regional Hospital | Clinic/Center | 98 Experiment Station Lane, Columbia, TN 38401-4700 | 2018-07-10 |
| 1194245399 | United Neighborhood Health Services, Inc. | Clinic/Center | 442 Metroplex Dr Ste 200, Nashville, TN 37211-3112 | 2017-06-20 |
| 1659745354 | Memphis Health Center, Inc. | Clinic/Center | 4250 Faronia Rd Ste 2a, Memphis, TN 38116-6527 | 2015-11-18 |
| 1639546187 | United Neighborhood Health Services, Inc. | Clinic/Center | 3904 Gallatin Pike, Nashville, TN 37216 | 2015-08-31 |
| 1790170389 | Maury Regional Hospital | Clinic/Center | 854 W James M Campbell Blvd Ste 301, Columbia, TN 38401-4659 | 2015-04-01 |
| 1285999128 | United Neighborhood Health Services, Inc | Clinic/Center | 401 Walton Ln, Nashville, TN 37216-1018 | 2012-07-06 |
| 1891058848 | United Neighborhood Health Services, Inc | Clinic/Center | 1900 Hobson Pike, Antioch, TN 37013-2421 | 2012-06-23 |
| Find all providers with the same taxonomy | ||||
| City | SNEEDVILLE |
| Zip Code | 37869 |
Please comment or provide details below to improve the information on EAST TENNESSEE STATE UNIVERSITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.