DICKENSON COMMUNITY HOSPITAL, INC. (NPI# 1285685727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285685727 |
| Entity Type | Organization |
| Organization Name | DICKENSON COMMUNITY HOSPITAL, INC. |
| Practice Address |
312 Hospital Dr Clintwood VA 24228-6786 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 2769260300 |
| Practice Fax Number | 2769260329 |
| Mailing Telephone | 2769260300 |
| Mailing Fax Number | 2769260329 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-02-05 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
H1918 | VA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010038146 | 05 | |
| VA | ANTHEM BLUE CROSS | 102340 | 01 |
| JOHN DEERE | A24228 00 | 01 | |
| KY | 01601087 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679992358 | Dickenson Community Hospital, Inc. | Clinical Nurse Specialist | 364 Hospital Dr, Clintwood, VA 24228 | 2014-04-10 |
| 1619029105 | Dickenson Community Hospital, Inc. | Medicare Defined Swing Bed Unit | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2007-01-17 |
| Street Address |
312 HOSPITAL DR |
| City | CLINTWOOD |
| State | VA |
| Zip Code | 24228-6786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063407773 | Jana K Dreyzehner | Psychiatry & Neurology | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2005-09-19 |
| 1659980373 | Christa Briana Setser | Nurse Practitioner | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2020-07-28 |
| 1073121125 | Christy Jolene Lambert | Nurse Practitioner | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2020-07-15 |
| 1376933580 | Dickenson Community Hospital, Inc | Psychiatric Unit | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2015-01-26 |
| 1841338498 | Ivory Brian Steffey | Social Worker | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2007-02-02 |
| 1619029105 | Dickenson Community Hospital, Inc. | Medicare Defined Swing Bed Unit | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2007-01-17 |
| 1811934698 | Rimon Ibrahim | Emergency Medicine | 312 Hospital Dr, Clintwood, VA 24228-6786 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851816953 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5451 Dickenson Hwy, Clintwood, VA 24228 | 2017-08-09 |
| 1669902243 | Mountain States Health Alliance | Hospice Care, Community Based | 312 Hospital Dr Suite 1b, Clintwood, VA 24228 | 2017-06-15 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1134667009 | Amy Meade | Pharmacist | 342 Main Street, Clintwood, VA 24228 | 2017-02-10 |
| 1881087385 | Family Preservation Services, Inc | Community/Behavioral Health | 1381 Rose Ridge Ct, Clintwood, VA 24228 | 2015-03-09 |
| 1477951515 | Tauna Gulley | Nurse Practitioner | 233 Chase Street, Suite 100, Clintwood, VA 24228 | 2014-12-05 |
| 1740696152 | Family Preservation Services, Inc. | Community/Behavioral Health | 5123 Dickenson Highway, Clintwood, VA 24228 | 2014-07-07 |
| 1962816884 | Family Preservation Services, Inc | Community/Behavioral Health | 5123 & 5127 Dickenson Highway, Clintwood, VA 24228 | 2014-06-18 |
| 1003163643 | Family Preservation Services, Inc | Community/Behavioral Health | 150 Elementary Circle, Clintwood, VA 24228 | 2012-08-14 |
| 1265739122 | Family Preservation Services, Inc. | Community/Behavioral Health | Technology Park Drive, Clintwood, VA 24228 | 2011-02-11 |
| Find all providers in zip 24228 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235316092 | Department of Veterans Affairs | General Acute Care Hospital | 13 S College Ave, Salem, VA 24153-3833 | 2008-01-23 |
| 1053521757 | Univeristy of Virginia Health System | General Acute Care Hospital | University of Virginia Health System, 1215 Lee Street, Chalrlottesville, VA 22908 | 2007-05-23 |
| 1902900202 | Pch Operations, LLC Dba R.j. Reynolds-patrick County Memorial Hospital | General Acute Care Hospital | 18688 Jeb Stuart Highway, Stuart, VA 24171 | 2006-09-08 |
| 1902807936 | Bath County Community Hospital | General Acute Care Hospital | 106 Park Drive, Hot Springs, VA 24445 | 2005-08-01 |
| 1205488996 | Mountain States Health Alliance | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2019-07-12 |
| 1205371549 | Bernardo Canga | General Acute Care Hospital | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2016-12-22 |
| 1699125526 | Chesapeake Hospital LLC | General Acute Care Hospital | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1740667229 | Norton Community Hospital | General Acute Care Hospital | 100 15th St Nw, Norton Community Hospital, Norton, VA 24273-1616 | 2015-05-04 |
| 1952792673 | Carilion Giles Community Hospital | General Acute Care Hospital | 159 Hartley Way, Pearisburg, VA 24134-2471 | 2015-02-17 |
| 1407252042 | Lee County Hospital Authority | General Acute Care Hospital | 127 Health Care Dr, Pennington Gap, VA 24277-2853 | 2014-11-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DICKENSON COMMUNITY HOSPITAL, INC..
| 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.