Healthcare Provider Details

I. General information

NPI: 1477823672
Provider Name (Legal Business Name): CHOTA COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 OLD HIGH SCHOOL RD
TELLICO PLAINS TN
37385-4965
US

IV. Provider business mailing address

PO BOX 278
MADISONVILLE TN
37354-0278
US

V. Phone/Fax

Practice location:
  • Phone: 423-442-2622
  • Fax:
Mailing address:
  • Phone: 423-442-2622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA HARRIS
Title or Position: CEO
Credential:
Phone: 423-442-7268