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ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER INC. NPI 1083752901


NPI Information

NPI: 1083752901
Provider Name: ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER, INC.
Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
3916 BOYDS BRIDGE PIKE
KNOXVILLE, TN
ZIP 37914
Phone: (865) 524-1500
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ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER, INC. is a nursing facility intermediate care facility in Knoxville, TN. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. ST. MARY'S HOLSTON HEALTH AND REHABILITATION CENTER, INC. NPI is 1083752901. The provider is registered as an organization entity type.

The provider's business location address is:

3916 BOYDS BRIDGE PIKE
KNOXVILLE, TN
ZIP 37914-233
Phone: (865) 524-1500
Fax: (865) 524-0408

The provider's authorized official is Angel David Jimenez .
The authorized official title is Interim Ceo and has the following contact phone number (865) 545-7558.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 12/2/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care Facility0000000333TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17440572MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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