SBH-KINGSPORT (NPI# 1174038749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174038749 |
Entity Type | Organization |
Organization Name | SBH-KINGSPORT |
Other Organization Name | CREEKSIDE BEHAVIORAL HEALTH |
Practice Address |
1025 Executive Park Blvd Kingsport TN 37660 |
Mailing Address |
8295 Tournament Dr Ste 201 Memphis TN 38125-8913 |
Practice Telephone | 9019693100 |
Mailing Telephone | 9019693100 |
Enumeration Date | 2017-12-05 |
Last Update Date | 2020-01-09 |
Authorized Official Name | MIRIAM CHAMBLISS (CORPORATE COMPLIANCE OFFICER) |
Authorized Official Telephone | 9019693111 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 283Q00000X | Psychiatric Hospital | Hospitals |
Other Name | Type Code |
---|---|
Creekside Behavioral Health | Doing Business As Name - Organization |
Street Address |
1025 EXECUTIVE PARK BLVD |
City | KINGSPORT |
State | TN |
Zip Code | 37660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205443058 | Clinton Davis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-09-25 |
1063021087 | Leslie Renee Trivett | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-07-27 |
1114543642 | Phillip Connors | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2020-06-20 |
1477103661 | Mary Evans | Social Worker | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-09-19 |
1063065621 | Stefani Ellis | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-07-22 |
1245798107 | Kelly Hyder | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2019-03-08 |
1285117606 | Shane Stephens | Nurse Practitioner | 1025 Executive Park Blvd, Kingsport, TN 37660-4620 | 2018-09-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
1316323231 | Alexandra Rebecca Mccracken | Speech-Language Pathologist | 301 Louis St. #101, Mountain Region Speech & Hearing Center, Kingsport, TN 37660 | 2015-08-03 |
Find all providers in zip 37660 |
Taxonomy Code | 283Q00000X |
Grouping | Hospitals |
Classification | Psychiatric Hospital |
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568006633 | Cumberland Behavioral Health, LLC | Psychiatric Hospital | 300 Great Circle Rd, Nashville, TN 37228-1752 | 2019-11-01 |
1124672704 | Tristar Maury Behavioral Healthcare, LLC | Psychiatric Hospital | 1001 N James M Campbell Blvd, Columbia, TN 38401-2689 | 2019-07-31 |
1306354790 | Erlanger Behavioral Health, LLC | Psychiatric Hospital | 804 North Holtzclaw Avenue, Chattanooga, TN 37404 | 2018-01-19 |
1114452216 | Cherie J Landon | Psychiatric Hospital | 7206 John Norton Rd, Knoxville, TN 37920-6630 | 2017-04-26 |
1952769119 | Crestwyn Health Group, LLC | Psychiatric Hospital | 9485 Crestwyn Hills Cove, Memphis, TN 38125 | 2016-02-03 |
1235516097 | Behavioral Healthcare Center At Memphis, Inc. | Psychiatric Hospital | 1505 N Second Street, Memphis, TN 38107 | 2015-04-30 |
1215324033 | Aaa Psychiatric Services, Pllc | Psychiatric Hospital | 5147 Wemberley Dr, Memphis, TN 38125-3469 | 2015-04-20 |
1932592953 | Generations Behavioral Health LLC | Psychiatric Hospital | 4423 Forsythe Place, Nashville, TN 37205 | 2015-03-16 |
1497012959 | Trustpoint Hospital, LLC | Psychiatric Hospital | 1009 N. Thompson Ln, Murfreesboro, TN 37128 | 2012-04-20 |
1346570777 | Behavioral Healthcare Center At Clarksville Inc | Psychiatric Hospital | 930 Professional Park Drive, Clarksville, TN 37040 | 2010-01-07 |
Find all providers with the same taxonomy |
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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.