| At Home Primary Care Inc | |
|
4662 E Circle Dr Nw Cleveland TN 37312-4101 | |
| (423) 790-6556 | |
| Not Available |
| Full Name | At Home Primary Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4662 E Circle Dr Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Jane G Patten (OFFICE MANAGER) |
| Authorized Official Contact | 4237907662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| At Home Primary Care Inc 4662 E Circle Dr Nw Cleveland TN 37312-4101 Ph: (423) 790-7662 | At Home Primary Care Inc 4662 E Circle Dr Nw Cleveland TN 37312-4101 Ph: (423) 790-6556 |
| NPI Number | 1891096061 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 11/08/2023 |
| Medicare PECOS PAC ID | 8325236953 |
|---|---|
| Medicare Enrollment ID | O20101227000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891096061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Vickie Renee M Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972552198 PECOS PAC ID: 2567475015 Enrollment ID: I20060728000261 |
| Provider Name | Walter W Rucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386644094 PECOS PAC ID: 2163511742 Enrollment ID: I20071204000841 |
| Provider Name | Traci C Grime |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548670557 PECOS PAC ID: 5092930065 Enrollment ID: I20140707001584 |
| Provider Name | Elizabeth M Crockett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912311911 PECOS PAC ID: 3072734425 Enrollment ID: I20141028001481 |
| Provider Name | Shannon Brittany Dedmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396298394 PECOS PAC ID: 9133413206 Enrollment ID: I20160811002852 |
| Provider Name | Robert L Kite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710496872 PECOS PAC ID: 5991056384 Enrollment ID: I20180925000343 |
| Provider Name | Brenda M Muzyngo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962997007 PECOS PAC ID: 6507118205 Enrollment ID: I20181008002484 |
| Provider Name | Jenna Brooke Cate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013495951 PECOS PAC ID: 1658617980 Enrollment ID: I20190108001816 |
| Provider Name | Rachel Denton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982220166 PECOS PAC ID: 7618397142 Enrollment ID: I20201021001891 |
| Provider Name | Kellye R L Fryar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063157857 PECOS PAC ID: 6507244076 Enrollment ID: I20220613001003 |
| Provider Name | Alexandra Cooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376288241 PECOS PAC ID: 0446631758 Enrollment ID: I20220718003666 |
| Provider Name | Alexa Pierson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467156661 PECOS PAC ID: 9436515103 Enrollment ID: I20230523000673 |
| Provider Name | Valentina Raney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992496673 PECOS PAC ID: 4688031321 Enrollment ID: I20230612000895 |
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