FAMILY MEDICAL CENTER OF DECHERD INC. NPI 1124218631

NPI Information

NPI: 1124218631
Provider Name: FAMILY MEDICAL CENTER OF DECHERD INC.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 44D0981032

Address:
3651 TULLAHOMA HWY
WINCHESTER, TN
ZIP 37398
Phone: (931) 962-4082
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FAMILY MEDICAL CENTER OF DECHERD INC. is a family nurse practitioner in Winchester, TN. FAMILY MEDICAL CENTER OF DECHERD INC. NPI is 1124218631. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3651 TULLAHOMA HWY
WINCHESTER, TN
ZIP 37398-940
Phone: (931) 962-4082
Fax: (931) 962-4084

The provider's authorized official is Kimberly A. Perry .
The authorized official title is President/family Nurse Practitioner and has the following contact phone number (931) 962-4082.

The CLIA number assigned to this NPI record is 44D0981032 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/31/2007 and was last updated on 8/6/2008.

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
1	363LF0000X	Nurse Practitioner	Family	6754	TENNESSEE	Yes

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
1	3724619	OTHER	TENNESSEE	RAILROAD MEDICARE
2	S11830	MEDICARE UPIN	TENNESSEE
3	3341708	OTHER	TENNESSEE	MEDICARE PPN
4	3724619	MEDICAID	TENNESSEE
5	3724619	MEDICARE PIN	TENNESSEE

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: 5/5/2024

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