NORTHWEST TENNESSEE DEVELOPMENT DISTRICT NPI 1114117751

NPI Information

  • NPI: 1114117751
  • Provider Name: NORTHWEST TENNESSEE DEVELOPMENT DISTRICT
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • Address: 124 WELDON DR
    MARTIN, TN
    ZIP 38237
  • Phone: (731) 587-4213

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NPI Details

NORTHWEST TENNESSEE DEVELOPMENT DISTRICT is a point of service in Martin, TN. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. NORTHWEST TENNESSEE DEVELOPMENT DISTRICT NPI is 1114117751. The provider is registered as an organization entity type.

The provider's business location address is:

124 WELDON DR
MARTIN, TN
ZIP 38237-308
Phone: (731) 587-4213

The provider's authorized official is John A Bucy .
The authorized official title is Executive Director and has the following contact phone number (731) 587-4213.

The enumeration date for this NPI number is 7/30/2007 and was last updated on 10/31/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of ServiceYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10445784MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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