Provider Demographics
| NPI: | 1134128820 |
|---|---|
| Name: | CHEROKEE HEALTH SYSTEMS |
| Entity Type: | Organization |
| Organization Name: | CHEROKEE HEALTH SYSTEMS |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JEFFREY |
| Authorized Official - Middle Name: | W |
| Authorized Official - Last Name: | HOWARD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 423-587-7337 |
| Mailing Address - Street 1: | 6350 W ANDREW JOHNSON HWY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TALBOTT |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37877-8605 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 800-355-3565 |
| Mailing Address - Fax: | 423-714-2355 |
| Practice Address - Street 1: | 6350 W ANDREW JOHNSON HWY |
| Practice Address - Street 2: | |
| Practice Address - City: | TALBOTT |
| Practice Address - State: | TN |
| Practice Address - Zip Code: | 37877-8605 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 423-587-7337 |
| Practice Address - Fax: | 423-586-0614 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-07-15 |
| Last Update Date: | 2020-09-30 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | Group - Multi-Specialty |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TN | 44-1902 | Medicaid | |
| TN | 3686393 | Medicaid | |
| TN | 3696394 | Medicare ID - Type Unspecified | |
| TN | 3686393 | Medicaid | |
| TN | 3686393 | Medicare ID - Type Unspecified | |
| TN | 44-1902 | Medicaid | |
| TN | 44-1902 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1881 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1829 | Medicare ID - Type Unspecified | FQHC |
| TN | 3686393 | Medicaid | |
| TN | 44-1882 | Medicaid | |
| TN | 44-1913 | Medicaid | |
| TN | 44-1909 | Medicaid | |
| TN | 44-1912 | Medicaid | |
| TN | 44-1911 | Medicaid | |
| TN | 3686393 | Medicare ID - Type Unspecified | |
| TN | 44-1911 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1883 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1908 | Medicaid | |
| TN | 44-1829 | Medicaid | |
| TN | 44-1884 | Medicaid | |
| TN | 44-1885 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1908 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1902 | Medicaid | |
| TN | 3706725 | Medicaid | |
| TN | 44-1880 | Medicaid | |
| TN | 44-1879 | Medicare ID - Type Unspecified | FQHC |
| TN | 3696394 | Medicaid | |
| TN | 44-1909 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1884 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1882 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1885 | Medicaid | |
| TN | 44-1883 | Medicaid | |
| TN | 44-1912 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1880 | Medicare ID - Type Unspecified | FQHC |
| TN | 44-1879 | Medicaid |
