STATE OF TENNESSEE


Address: 2495 Buckingham Road, Greeneville, TN 37743
Phone: 4237870414

STATE OF TENNESSEE (NPI# 1215200118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215200118
Entity Type Organization
Organization Name STATE OF TENNESSEE
Other Organization Name DIDD EAST TN COMMUNITY HOMES
Practice Address 2495 Buckingham Road
Greeneville
TN 37743
Mailing Address 190 Serral Dr
Greeneville
TN 37745-3074
Practice Telephone 4237870414
Practice Fax Number 4237876092
Mailing Telephone 4237876757
Mailing Fax Number 4237876092
Enumeration Date 2012-02-23
Last Update Date 2012-02-23
Authorized Official Name MRS. MARGI E STORY (DIRECTOR)
Authorized Official Telephone 4237876757
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded I000000010289 TN Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
TN TAXONOMY 31500000X 01

Other Provider/Organization Names

Other Name Type Code
DIDD East TN Community Homes Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1417337056 State of Tennessee Physical Therapist 400 Deaderick St, Citizens Plaza, 9th Floor, Nashville, TN 37243-0001 2015-06-08
1023412020 State of Tennessee Intermediate Care Facility, Mentally Retarded 2324 Asheville Highway, Greeneville, TN 37743 2014-10-20
1871997163 State of Tennessee Intermediate Care Facility, Mentally Retarded 803 Redbud Dr, Greeneville, TN 37743-6141 2014-10-15
1437552536 State of Tennessee Intermediate Care Facility, Mentally Retarded 645 Rambo Road, Greeneville, TN 37743 2014-10-02
1114330545 State of Tennessee Occupational Therapist 301 Stewarts Ferry Pike, Didd Middle Tn Seating and Positioning Clinic, Nashville, TN 37214-3340 2014-06-03
1356770531 State of Tennessee Public Health or Welfare 1660 Silverado Ct, Sevierville, TN 37876-4426 2013-11-07
1699104885 State of Tennessee Public Health or Welfare 485 Sulphur Hollow Rd, Tazewell, TN 37879-5170 2013-11-07
1780958454 State of Tennessee Intermediate Care Facility, Mentally Retarded 2497 Buckingham Rd., Greeneville, TN 37743 2012-02-28
1629342415 State of Tennessee Intermediate Care Facility, Mentally Retarded 102 Dyer St., Greeneville, TN 37743 2012-02-27
1639443419 State of Tennessee Intermediate Care Facility, Mentally Retarded 2499 Buckingham Rd., Greeneville, TN 37745 2012-02-27

Office Location

Street Address 2495 BUCKINGHAM ROAD
City GREENEVILLE
State TN
Zip Code 37743

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023412020 State of Tennessee Intermediate Care Facility, Mentally Retarded 2324 Asheville Highway, Greeneville, TN 37743 2014-10-20
1437552536 State of Tennessee Intermediate Care Facility, Mentally Retarded 645 Rambo Road, Greeneville, TN 37743 2014-10-02
1205264058 Robert Maddox Social Worker 421 5th Ave North, Employee Health Clinic, 2nd Floor Central Services Bldg, Nashville, TN 37743 2013-10-14
1336574326 Cathy J Davis Occupational Therapy Assistant 910 West Summer Street, Greeneville, TN 37743 2013-09-09
1659614238 Person Centered Choices, LLC In Home Supportive Care 615 W. Main St., Ste. 204, Greeneville, TN 37743 2013-04-01
1730449943 Jenilee Stepp Behavioral Analyst 1007 West Main Suite B, Greenville, TN 37743 2012-05-22
1083971303 Jessica Allison Mcafee Registered Nurse 401 Takoma Ave., Suite 1, Second Floor, Greeneville, TN 37743 2012-04-12
1780958454 State of Tennessee Intermediate Care Facility, Mentally Retarded 2497 Buckingham Rd., Greeneville, TN 37743 2012-02-28
1629342415 State of Tennessee Intermediate Care Facility, Mentally Retarded 102 Dyer St., Greeneville, TN 37743 2012-02-27
1619244308 Amanda Evoughn Swatzell Licensed Practical Nurse 616 E Church Street Suite A, Greeneville, TN 37743 2011-11-23
Find all providers in zip 37743

Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891221271 Sunrise Community of Tennessee, Inc. Intermediate Care Facility, Mentally Retarded 640 Old Shiloh Rd, Greeneville, TN 37745-0556 2017-05-04
1154862340 Open Arms Care Corporation Intermediate Care Facility, Mentally Retarded 1404 East Church St, Greeneville, TN 37745 2017-03-20
1770024010 Open Arms Care Corporation Intermediate Care Facility, Mentally Retarded 1406 East Church Street, Greeneville, TN 37745 2017-03-20
1336685569 D&s Residential Services, Lp Intermediate Care Facility, Mentally Retarded 1010 Old Stage Rd, Greeneville, TN 37745 2017-01-11
1023412020 State of Tennessee Intermediate Care Facility, Mentally Retarded 2324 Asheville Highway, Greeneville, TN 37743 2014-10-20
1871997163 State of Tennessee Intermediate Care Facility, Mentally Retarded 803 Redbud Dr, Greeneville, TN 37743-6141 2014-10-15
1437552536 State of Tennessee Intermediate Care Facility, Mentally Retarded 645 Rambo Road, Greeneville, TN 37743 2014-10-02
1780958454 State of Tennessee Intermediate Care Facility, Mentally Retarded 2497 Buckingham Rd., Greeneville, TN 37743 2012-02-28
1629342415 State of Tennessee Intermediate Care Facility, Mentally Retarded 102 Dyer St., Greeneville, TN 37743 2012-02-27
1639443419 State of Tennessee Intermediate Care Facility, Mentally Retarded 2499 Buckingham Rd., Greeneville, TN 37745 2012-02-27
Find all providers in GREENEVILLE

Competitor

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City GREENEVILLE
Zip Code 37743

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Dataset Information

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.

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