Covenant Family Practice, Pc | |
1000 Highway 76 Clarksville TN 37043-8405 | |
(931) 245-8000 | |
(931) 245-0605 |
Full Name | Covenant Family Practice, Pc |
---|---|
Speciality | Family Medicine |
Location | 1000 Highway 76, Clarksville, Tennessee |
Authorized Official Name and Position | Robert Alan Wilson (PRESIDENT) |
Authorized Official Contact | 9312451150 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Covenant Family Practice, Pc Po Box 30459 Clarksville TN 37040-0008 Ph: (931) 245-8000 | Covenant Family Practice, Pc 1000 Highway 76 Clarksville TN 37043-8405 Ph: (931) 245-8000 |
NPI Number | 1225073166 |
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Provider Enumeration Date | 06/17/2006 |
Last Update Date | 11/05/2019 |
Medicare PECOS PAC ID | 6305839093 |
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Medicare Enrollment ID | O20040407000983 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225073166 | NPI | - | NPPES |
3718348 | Medicaid | TN | |
4062086 | Other | TN | TN BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christa A Blane |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851327977 PECOS PAC ID: 0446263685 Enrollment ID: I20060711000188 |
Provider Name | Robert Alan Wilson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699782557 PECOS PAC ID: 1850577909 Enrollment ID: I20110916000297 |
Provider Name | Tammy Greenhill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689946857 PECOS PAC ID: 9335303247 Enrollment ID: I20120605000534 |
Provider Name | David W Johnson |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1295882348 PECOS PAC ID: 2163325606 Enrollment ID: I20160523001521 |
Provider Name | Jewell Kaylor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174961445 PECOS PAC ID: 2769618982 Enrollment ID: I20161227001784 |
Provider Name | Mandy Childers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255743373 PECOS PAC ID: 5799906541 Enrollment ID: I20171221002299 |
Provider Name | Rita Peters |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013482454 PECOS PAC ID: 6507107489 Enrollment ID: I20190402000947 |
Provider Name | Olivia G Hutcheson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780148460 PECOS PAC ID: 7618218348 Enrollment ID: I20190408000874 |
Provider Name | Sarah Davenport Ziegler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750846309 PECOS PAC ID: 8224467519 Enrollment ID: I20200408001002 |
Provider Name | Kara Coleman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558740415 PECOS PAC ID: 5698066090 Enrollment ID: I20210505001945 |
Provider Name | Katherine L Arenz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043460751 PECOS PAC ID: 4587836986 Enrollment ID: I20210525001118 |
Provider Name | Melinda Faye Haddock-diaz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427723089 PECOS PAC ID: 2365849056 Enrollment ID: I20210922003210 |
Provider Name | Hilliary Maria Wynn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437511870 PECOS PAC ID: 5698166361 Enrollment ID: I20220107000196 |
Provider Name | Kathryn L Scoville |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194758359 PECOS PAC ID: 3173543972 Enrollment ID: I20230131003029 |
Provider Name | Kristina M Reilly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043992449 PECOS PAC ID: 5799139655 Enrollment ID: I20230926002155 |
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