FAMILY MEDICAL CARE CENTER LLC NPI 1508021890

NPI Information

NPI: 1508021890
Provider Name: FAMILY MEDICAL CARE CENTER, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
7331 TAZEWELL PIKE
CORRYTON, TN
ZIP 37721
Phone: (865) 687-3622
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FAMILY MEDICAL CARE CENTER, LLC is a family nurse practitioner in Corryton, TN. FAMILY MEDICAL CARE CENTER, LLC NPI is 1508021890. The provider is registered as an organization entity type.

The provider's business location address is:

7331 TAZEWELL PIKE
CORRYTON, TN
ZIP 37721-516
Phone: (865) 687-3622
Fax: (865) 687-3632

The provider's authorized official is Jamie Bull .
The authorized official title is Managing Member and has the following contact phone number (865) 687-3622.

The enumeration date for this NPI number is 7/25/2008 and was last updated on 3/17/2015.

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	261QP2300X	Clinic/Center	Primary Care		TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family			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	1521139	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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