JELLICO HEALTHCARE ASSOCIATES LLC (NPI# 1497297949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497297949 |
| Entity Type | Organization |
| Organization Name | JELLICO HEALTHCARE ASSOCIATES LLC |
| Practice Address |
188 Hospital Ln Jellico TN 37762-4400 |
| Practice Telephone | 4237847252 |
| Mailing Telephone | 4237847252 |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2016-11-15 |
| Authorized Official Name | MRS. KIM DOWELL (CEO) |
| Authorized Official Telephone | 4237847252 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
188 HOSPITAL LN |
| City | JELLICO |
| State | TN |
| Zip Code | 37762-4400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255300182 | Terrence Wesley Leveck | Emergency Medicine | 188 Hospital Ln, Jellico Community Hospital, Jellico, TN 37762-4400 | 2006-03-14 |
| 1083171664 | Jellico Medical Center, Inc. | General Acute Care Hospital | 188 Hospital Ln, Jellico, TN 37762-4400 | 2019-03-01 |
| 1992253025 | Hcc of Jellico LLC | Internal Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2016-09-19 |
| 1932551041 | Ess of Jellico LLC | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2016-07-13 |
| 1528436334 | Shonda Lynn Tucker | Nurse Practitioner | 188 Hospital Ln, Jellico, TN 37762-4400 | 2015-09-10 |
| 1073898714 | Jellico Community Hospital, Inc | Clinic/Center | 188 Hospital Ln, Jellico, TN 37762-4400 | 2011-10-13 |
| 1124322847 | Jellico Emergency Physicians Medical Group PC | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2011-01-10 |
| 1649442237 | Bishofberger Medical Associates of East Tennessee | Surgery | 188 Hospital Ln, Jellico, TN 37762-4400 | 2008-03-24 |
| 1407024979 | Pine Mountain Emergency Physicians | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2008-02-18 |
| 1871774042 | Pedro Pablo Flores | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2007-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063992600 | Springs of Life | Psychologist | 185 Baker Street, Jellico, TN 37762 | 2018-08-14 |
| 1679666366 | Charles Henry Wilkens | Family Medicine | 131 Hospital Lane, Jellico, TN 37762 | 2006-10-02 |
| 1225096217 | Benjamin Wayne D'ooge | Emergency Medicine | 188 Hospital Lane, Jellico, TN 37762 | 2006-05-02 |
| 1770790065 | Dayspring Health Inc | Physician Assistant | 107 S Main St, Jellico, TN 37762 | 2007-05-17 |
| 1023022084 | Dayspring Health Inc | Obstetrics & Gynecology | 550 Sunset Trl, Jellico, TN 37762 | 2006-07-27 |
| 1174691315 | Family Drug Center Inc | Durable Medical Equipment & Medical Supplies | 248 S Main St, Jellico, TN 37762-2017 | 2006-12-04 |
| 1114442175 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 248 S Main St, Jellico, TN 37762-2017 | 2017-08-10 |
| 1598211401 | Jonathan Broyles | Pharmacist | 248 S Main St, Jellico, TN 37762-2017 | 2016-08-30 |
| 1184008005 | Rite Aid of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 248 S Main St, Jellico, TN 37762-2017 | 2015-07-10 |
| 1134589823 | Walter Stephens | Physical Therapist | 269 S Main St, Jellico, TN 37762-2018 | 2016-02-24 |
| Find all providers in zip 37762 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427096551 | David Escalante | Emergency Medicine | 292 N Main St, Jellico, TN 37762-2132 | 2006-06-02 |
| 1225096217 | Benjamin Wayne D'ooge | Emergency Medicine | 188 Hospital Lane, Jellico, TN 37762 | 2006-05-02 |
| 1255300182 | Terrence Wesley Leveck | Emergency Medicine | 188 Hospital Ln, Jellico Community Hospital, Jellico, TN 37762-4400 | 2006-03-14 |
| 1932551041 | Ess of Jellico LLC | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2016-07-13 |
| 1124322847 | Jellico Emergency Physicians Medical Group PC | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2011-01-10 |
| 1407024979 | Pine Mountain Emergency Physicians | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2008-02-18 |
| 1871774042 | Pedro Pablo Flores | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2007-11-16 |
| 1386686343 | Ruchi Gupta | Emergency Medicine | 188 Hospital Ln, Jellico, TN 37762-4400 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801418710 | Tn Tele Md PC | Emergency Medicine | 578 Ivy Dr, Oakland, TN 38060-3132 | 2020-05-13 |
| 1891287090 | Shelby Linwood Gillette Jr. | Emergency Medicine | 170 S Goodlett St Ste A, Memphis, TN 38117-2914 | 2018-06-04 |
| 1225529621 | Hometown Family Medical | Emergency Medicine | 909 Hillsboro Blvd, Manchester, TN 37355-2025 | 2018-05-22 |
| 1780181016 | Jacob Wilson | Emergency Medicine | 1313 21st Avenue, South, 703 Oxford House, Nashville, TN 37232-4700 | 2018-04-12 |
| 1285155531 | Terry Curtis Fultz | Emergency Medicine | 2807 Wallace Ct, Kingsport, TN 37664-5832 | 2017-06-27 |
| 1194255216 | Front Door Medicine Pllc | Emergency Medicine | 3276 Chestnut Cir Nw, Cleveland, TN 37312-2113 | 2017-06-13 |
| 1710413885 | Michael Sidney Reich | Emergency Medicine | 665 Tennessee St, Memphis, TN 38103-8794 | 2017-05-10 |
| 1669907325 | Stephen Lee | Emergency Medicine | 1005 Dr. D B Todd Jr. Blvd., Old Hosp. Bldg., 3rd Floor, Nashville, TN 37208-1224 | 2017-05-01 |
| 1215468277 | Jarrett Woock | Emergency Medicine | 7402 Lee Hwy, Chattanooga, TN 37421-1405 | 2017-03-22 |
| 1871049023 | Keystone Medical Services of West Point Inc | Emergency Medicine | 6075 Poplar Avenue, Suite 401, Memphis, TN 38119-0114 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JELLICO HEALTHCARE ASSOCIATES LLC.
| 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.