STATE OF TENNESSEE; NPI #1740331792

Contact Information

STATE OF TENNESSEE

240 COLONIAL CIRCLE
SUITE A
JAMESTOWN, TN 38556-3924

Phone: 931-879-9936
Fax: 931-879-9938
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Public Health or Welfare	251K00000X	60	Public Health or Welfare Agency

Indicates primary specialty

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NPI Profile & details for STATE OF TENNESSEE

NPI # 1740331792

LBN Legal business name STATE OF TENNESSEE

Authorized official TAMMY STEWART - (CFO)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/16/2007

Last updated 01/07/2025 - More than a year ago

Identifiers

TN	License #	=========
TN	Medicaid	444-7864

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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