Provider Demographics
NPI:1639141351
Name:BAPTIST HOSPITAL OF EAST TENNESSEE, INC.
Entity Type:Organization
Organization Name:BAPTIST HOSPITAL OF EAST TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ASHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-545-7557
Mailing Address - Street 1:137 E BLOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1601
Mailing Address - Country:US
Mailing Address - Phone:865-632-5011
Mailing Address - Fax:
Practice Address - Street 1:137 E BLOUNT AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1601
Practice Address - Country:US
Practice Address - Phone:865-632-5011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-06
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000040273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN004T019Medicaid
44T019Medicare Oscar/Certification