| Cleveland Psychiatric Center, Pc | |
|
1723 Mount Vernon Dr Nw Cleveland TN 37311-3539 | |
| (423) 473-2633 | |
| (423) 473-2643 |
| Full Name | Cleveland Psychiatric Center, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1723 Mount Vernon Dr Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Jerry Glynn Newman (PSYCHIATRIST/OWNER) |
| Authorized Official Contact | 4234732633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleveland Psychiatric Center, Pc 1723 Mount Vernon Dr Nw Cleveland TN 37311-3539 Ph: (423) 473-2633 | Cleveland Psychiatric Center, Pc 1723 Mount Vernon Dr Nw Cleveland TN 37311-3539 Ph: (423) 473-2633 |
| NPI Number | 1972799146 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Medicare PECOS PAC ID | 5799717526 |
|---|---|
| Medicare Enrollment ID | O20050901000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972799146 | NPI | - | NPPES |
| 3332735 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 40005 (Tennessee) | Primary |
| Provider Name | Jerry G Newman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962401760 PECOS PAC ID: 3779515507 Enrollment ID: I20050906000834 |
| Provider Name | Michael R Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790906436 PECOS PAC ID: 6002917556 Enrollment ID: I20070727000171 |
| Provider Name | George K Mcbride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962061473 PECOS PAC ID: 7719217504 Enrollment ID: I20190920001026 |
| Provider Name | Julie N Mcbride |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598324006 PECOS PAC ID: 8729411897 Enrollment ID: I20191203001533 |
| Provider Name | Jaclyn Mc Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023730298 PECOS PAC ID: 1557739711 Enrollment ID: I20221118000636 |
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