EAST TENNESSEE STATE UNIVERSITY NPI 1477660199

NPI Information

NPI: 1477660199
Provider Name: EAST TENNESSEE STATE UNIVERSITY

Doing Business As: JOHNSON CITY COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2151 CENTURY LANE
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 926-2500
Get Directions

EAST TENNESSEE STATE UNIVERSITY is a federally qualified health center (fqhc) clinic center in Johnson City, TN. EAST TENNESSEE STATE UNIVERSITY NPI is 1477660199. The provider is registered as an organization entity type.
The provider Is Doing Business As Johnson City Community Health Center.

The provider's business location address is:

2151 CENTURY LANE
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 926-2500
Fax: (423) 926-5999

The provider's authorized official is Betty J King .
The authorized official title is Senior Associate Vice President F&a and has the following contact phone number (423) 439-4414.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 7/21/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0441901	MEDICAID	TENNESSEE

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

NPI Synchronization or Removal

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