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JELLICO COMMUNITY HOSPITAL
NPI 1699794578
Medicare Defined Swing Bed Unit in Jellico, TN

Active since July 19, 2006
188 HOSPITAL LANE, JELLICO, TN 37762(423) 784-1334(423) 784-1136 Get Directions Write a Review

NPPES record last updated: June 7, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jellico Community Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JELLICO COMMUNITY HOSPITAL (NPI 1699794578) is a healthcare organization registered as a medicare defined swing bed unit in Jellico, Tennessee and active in the NPI registry since July 2006. The organization lists Evelyn Ghulam, Controller, as its authorized official.

NPPES Registry Identity

NPI1699794578
Entity TypeOrganization
Primary Taxonomy275N00000X
Legal Business NameJELLICO COMMUNITY HOSPITAL INC.
Location Address188 HOSPITAL LANEJellico, TN 37762-4400
Mailing AddressPo Box 844869Dallas, TX 75284-4869 · (423) 784-1334 · Fax (423) 784-1336
Phone(423) 784-1334
Fax(423) 784-1136
Organization SubpartNo
Authorized OfficialEvelyn GhulamController · (423) 784-1334
Enumeration DateJuly 19, 2006
Last NPPES UpdateJune 7, 2016
✔ NPI 1699794578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMedicare Defined Swing Bed UnitHospital Units
Taxonomy Code275N00000X
License✔ Licensed in TN · 0000000007
Definition
A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit.
188 HOSPITAL LANE, Jellico, TN 37762
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Other Names 1

Doing Business AsJellico Community Hospital

Other Identifiers 14

Other54976TN · Anthem Blue Cross
Medicaid0440180TN
OtherA3776201TN · Tc Ambulance
OtherA3776201TN · John Deere Commercial
Other440180TN · Medicare Managed Care
Other1000250TN · Blue Cross Blue Shield
Other1530476TN · United Mine Workers
Medicaid01620848KY
Other1000250TN · Tc Ambulance
Other397905000TN · Federal Black Lung
Other440180TN · Tc Ambulance
Medicare OSCAR/certification44U180FL
Other6530360TN · Aetna
Other55620496TN · Unisys Ambulance

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BENJAMIN WAYNE D'OOGE M.D.
Emergency Medicine
188 HOSPITAL LANE
JELLICO, TN 37762
Campbell County (800) 944-7252
JELLICO COMMUNITY HOSPITAL, INC
Skilled Nursing Facility
188 HOSPITAL LANE
JELLICO, TN 37762
Campbell County (423) 784-1272

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jellico Community Hospital Inc.'s NPI number?

The NPI number for Jellico Community Hospital Inc. is 1699794578. It was assigned to this organization in the NPPES registry on July 19, 2006. The provider is doing business as Jellico Community Hospital.

Where is Jellico Community Hospital Inc. located?

Jellico Community Hospital Inc. is located at 188 Hospital Lane, Jellico, TN 37762. The listed phone number is (423) 784-1334.

What is Jellico Community Hospital Inc.'s specialty?

The primary specialty registered for this NPI is Medicare Defined Swing Bed Unit with taxonomy code 275N00000X.

When was this NPI record last updated?

The NPPES record for Jellico Community Hospital Inc. was last updated on June 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.