MCKENZIE MEDICAL CENTER PC NPI 1245401231

NPI Information

  • NPI: 1245401231
  • Provider Name: MCKENZIE MEDICAL CENTER PC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: HOMETOWN HEALTH CLINIC
  • CLIA Number: 44D0315280
  • Address: 30810 BROAD ST
    BRUCETON, TN
    ZIP 38317
  • Phone: (731) 586-4800

Map and Directions

Get Directions

NPI Details

MCKENZIE MEDICAL CENTER PC is a rural health clinic center in Bruceton, TN. MCKENZIE MEDICAL CENTER PC NPI is 1245401231. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Hometown Health Clinic.

The provider's business location address is:

30810 BROAD ST
BRUCETON, TN
ZIP 38317-028
Phone: (731) 586-4800
Fax: (833) 690-3848

The provider's authorized official is Tammy Etheridge .
The authorized official title is Chief Operating Officer and has the following contact phone number (731) 352-7907.

The CLIA number assigned to this NPI record is 44D0315280 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/18/2008 and was last updated on 5/6/2024.

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
1152W00000XOptometristODT1599TENNESSEENo
2207Q00000XFamily MedicineMD23833TENNESSEENo
3261QR1300XClinic/CenterRural HealthYes
4363A00000XPhysician AssistantNo
5363LF0000XNurse PractitionerFamilyNo

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
13380640OTHERTENNESSEEMEDICARE GROUP
23380640OTHERTENNESSEEMEDICAID GROUP

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI