| Takoma Regional Hospital Inc | |
|
1420 Tusculum Blvd Greeneville TN 37745-4279 | |
| (423) 787-5000 | |
| (423) 787-5147 |
| Full Name | Takoma Regional Hospital Inc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1420 Tusculum Blvd, Greeneville, Tennessee |
| Authorized Official Name and Position | Shane Edwin Hilton (EVP/CFO) |
| Authorized Official Contact | 4233023467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Takoma Regional Hospital Inc 311 Princeton Rd Ste 1 Johnson City TN 37601-2080 Ph: (423) 787-5000 | Takoma Regional Hospital Inc 1420 Tusculum Blvd Greeneville TN 37745-4279 Ph: (423) 787-5000 |
| NPI Number | 1699819003 |
|---|---|
| Provider Enumeration Date | 02/18/2007 |
| Last Update Date | 04/22/2025 |
| Medicare PECOS PAC ID | 8729189295 |
|---|---|
| Medicare Enrollment ID | O20070727000394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699819003 | NPI | - | NPPES |
| 3774303 | Other | TN | JOHN DEERE |
| 100020449 | Other | TN | PREFERRED HEALTH |
| 4147074 | Other | TN | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | (* (Not Available)) | Primary |
| Provider Name | Michael D Stone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821017252 PECOS PAC ID: 1456259456 Enrollment ID: I20031229000899 |
| Provider Name | Rhonda Malina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720078561 PECOS PAC ID: 6204823974 Enrollment ID: I20040427000166 |
| Provider Name | Richard J Aasheim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831139005 PECOS PAC ID: 9436118908 Enrollment ID: I20041008001140 |
| Provider Name | William C Diebold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770573511 PECOS PAC ID: 9638110034 Enrollment ID: I20050516000932 |
| Provider Name | Michael J Odell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477593143 PECOS PAC ID: 6103858154 Enrollment ID: I20061204000251 |
| Provider Name | Margeaux Clements |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902941024 PECOS PAC ID: 8628169554 Enrollment ID: I20070807000817 |
| Provider Name | Howard E Herrell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043404601 PECOS PAC ID: 2668543026 Enrollment ID: I20080612000739 |
| Provider Name | Daniel Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902821069 PECOS PAC ID: 6608871603 Enrollment ID: I20080809000141 |
| Provider Name | Laura P Doty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629274345 PECOS PAC ID: 6901990571 Enrollment ID: I20091229000460 |
| Provider Name | Joseph M Kretschmar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699763649 PECOS PAC ID: 3274620968 Enrollment ID: I20100928001477 |
| Provider Name | Karen M Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063544666 PECOS PAC ID: 0345406070 Enrollment ID: I20120725000429 |
| Provider Name | Zachary A Hammons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073779799 PECOS PAC ID: 6709075690 Enrollment ID: I20120821000340 |
| Provider Name | Beth Ann Bulawa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285620781 PECOS PAC ID: 6002834751 Enrollment ID: I20130917000233 |
| Provider Name | Erick C Bulawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326020199 PECOS PAC ID: 5799798435 Enrollment ID: I20131029001688 |
| Provider Name | Arvo Kanna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164489589 PECOS PAC ID: 5294723169 Enrollment ID: I20131125000434 |
| Provider Name | Paula M Renner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992136469 PECOS PAC ID: 5092946798 Enrollment ID: I20140321001357 |
| Provider Name | Leah A Balch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225451925 PECOS PAC ID: 4587897053 Enrollment ID: I20140507002000 |
| Provider Name | Jami N Goodwin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811209620 PECOS PAC ID: 5092938977 Enrollment ID: I20140521002115 |
| Provider Name | Li Hua |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780812198 PECOS PAC ID: 9032434758 Enrollment ID: I20151016002207 |
| Provider Name | Debra D Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447543970 PECOS PAC ID: 9739303207 Enrollment ID: I20170626002284 |
| Provider Name | Amber N Mullins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215295324 PECOS PAC ID: 5597037093 Enrollment ID: I20170817003624 |
| Provider Name | Jessica E Pugh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982047650 PECOS PAC ID: 6406102052 Enrollment ID: I20180711004029 |
| Provider Name | Syed Shiraz Shiraz Hyder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245383108 PECOS PAC ID: 1951395938 Enrollment ID: I20181019000709 |
| Provider Name | Alice V Lilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972067395 PECOS PAC ID: 9739417536 Enrollment ID: I20190816003015 |
| Provider Name | Laken A Schang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881109940 PECOS PAC ID: 6709128929 Enrollment ID: I20200506002895 |
| Provider Name | Benjamin Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861888927 PECOS PAC ID: 0840507729 Enrollment ID: I20200707002163 |
| Provider Name | Phillip Connors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114543642 PECOS PAC ID: 8325464217 Enrollment ID: I20200824000745 |
| Provider Name | Amanda L Herrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114449337 PECOS PAC ID: 9830517572 Enrollment ID: I20200914000569 |
| Provider Name | Maci A Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942962519 PECOS PAC ID: 5890184345 Enrollment ID: I20211123000286 |
| Provider Name | Amy Leigh Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639832645 PECOS PAC ID: 0749672418 Enrollment ID: I20220110002329 |
| Provider Name | Zachary Gamble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669901435 PECOS PAC ID: 7214202886 Enrollment ID: I20220806000442 |
| Provider Name | Tammy Melissa Melissa Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801379078 PECOS PAC ID: 9830569748 Enrollment ID: I20230110000605 |
| Provider Name | Donna Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053612812 PECOS PAC ID: 9537530498 Enrollment ID: I20230201000854 |
| Provider Name | Lillian Arriona Yates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497408132 PECOS PAC ID: 1557734589 Enrollment ID: I20230222001539 |
| Provider Name | Angela Tolley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942651120 PECOS PAC ID: 7315368578 Enrollment ID: I20231228001233 |
| Provider Name | Emily L. Newland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548748882 PECOS PAC ID: 9133568439 Enrollment ID: I20240419000762 |
| Provider Name | Oyeronke Omodele Faleke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649025537 PECOS PAC ID: 0446792790 Enrollment ID: I20240603001453 |
| Provider Name | Sarah E. Devault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457166597 PECOS PAC ID: 8022539055 Enrollment ID: I20250306003082 |
Greeneville Physician Services, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1406 Tusculum Blvd, Suite 1200, Greeneville, TN 37745 Phone: 423-783-5520 Fax: 423-783-5521 | |
King's Way Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 318 Tusculum Blvd, Greeneville, TN 37745 Phone: 423-639-7700 Fax: 423-639-7700 | |
Horner Montgomery & Breckenridge Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 E Church St, Greeneville, TN 37745 Phone: 423-638-4131 Fax: 423-638-9239 | |
Id Consultant Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 Tusculum Blvd, Greeneville, TN 37745 Phone: 423-783-6400 Fax: 423-787-5146 | |
Summit Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 Justis Dr, Greeneville, TN 37745 Phone: 423-783-7965 Fax: 423-783-7970 | |
E. Bradford Strange, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Professional Plaza, Greeneville, TN 37745 Phone: 423-639-7141 Fax: 423-639-5241 | |
Greene County Employee Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Takoma Ave Ste 207, Greeneville, TN 37743 Phone: 423-798-2053 Fax: 423-798-2054 |