MEDICARE: STATE OF TENNESSEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency		TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033262530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATE OF TENNESSEE

Provider Business Mailing Address
First Line	:	60 E COURT SQ
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-4166
Country	:	US
Telephone Number	:	931-289-3463
Fax Number	:	931-289-3499

Provider Business Practice Location Address
First Line	:	60 E COURT SQ
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-4166
Country	:	US
Telephone Number	:	931-289-3463
Fax Number	:	931-289-3499

Authorized Official
Title or Position	:	REGIONAL DIRECTOR
Name	:	MRS. ANNETTE HALEY
Credential	:
Telephone Number	:	615-650-7000

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/28/2012

Similar Medicare Providers

1720053697 — AMERICAN HOMEPATIENT, INC.
Practice Location Address:

30 COURT SQ
ERIN, TN
37061-4166

Practice Phone: 931-289-4358
Practice Fax: 931-289-4500

1144758947 — LISA RAE BASS LPN
Practice Location Address:

60 COURT SQ
ERIN, TN
37061-4166

Practice Phone: 931-289-3463
Practice Fax: 931-289-3499

1518838317 — CARRIE BETH DUNAVANT RN
Practice Location Address:

60 COURT SQ
ERIN, TN
37061-4166

Practice Phone: 931-289-3463
Practice Fax:

1790167120 — DR. LEANN JOHNSON AU.D.
Practice Location Address:

3661 HIGHWAY 231
ERIN, TN
37061

Practice Phone: 970-673-5182
Practice Fax:

1932189800 — HQM OF ERIN, LLC
Practice Location Address:

242 ROCKY HOLLOW ROAD
ERIN, TN
37061

Practice Phone: 931-289-4141
Practice Fax:

1114980349 — DR. JOHN S PAFFRATH DDS
Practice Location Address:

4889 EAST MAIN STREET
ERIN, TN
37061-4115

Practice Phone: 931-289-4228
Practice Fax: 931-289-5832

Directions to “STATE OF TENNESSEE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.