| Frix-jennings Clinic Pc | |
|
116 W Main St Henderson TN 38340-2231 | |
| (731) 989-0001 | |
| (731) 989-5151 |
| Full Name | Frix-jennings Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 116 W Main St, Henderson, Tennessee |
| Authorized Official Name and Position | Carey Wallace Frix (PRESIDENT) |
| Authorized Official Contact | 7319890001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frix-jennings Clinic Pc 116 W Main St Henderson TN 38340-2231 Ph: (731) 989-0001 | Frix-jennings Clinic Pc 116 W Main St Henderson TN 38340-2231 Ph: (731) 989-0001 |
| NPI Number | 1174749469 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 03/07/2008 |
| Medicare PECOS PAC ID | 7618934449 |
|---|---|
| Medicare Enrollment ID | O20041214000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174749469 | NPI | - | NPPES |
| DA6267 | Other | TN | RAILROAD MEDICARE |
| 3372940 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34836 (Tennessee) | Primary |
| 207R00000X | Internal Medicine | 34823 (Tennessee) | Secondary |
| Provider Name | Tammi M Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023066057 PECOS PAC ID: 8325939135 Enrollment ID: I20040322001584 |
| Provider Name | Alexander P Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861445611 PECOS PAC ID: 4486636941 Enrollment ID: I20040607001153 |
| Provider Name | Betty A Roe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083692164 PECOS PAC ID: 3476532813 Enrollment ID: I20040719000576 |
| Provider Name | Bernhard Eric Dietz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497759807 PECOS PAC ID: 8123007416 Enrollment ID: I20040719001608 |
| Provider Name | Laquita W Bain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437238938 PECOS PAC ID: 1456305762 Enrollment ID: I20050309000901 |
| Provider Name | Carey W Frix |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235124223 PECOS PAC ID: 1759348592 Enrollment ID: I20060106000792 |
| Provider Name | Nicole M Jennings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801881891 PECOS PAC ID: 6608061015 Enrollment ID: I20101111000410 |
| Provider Name | Alison Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073829180 PECOS PAC ID: 9537343454 Enrollment ID: I20110418000336 |
| Provider Name | Angela D Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386942134 PECOS PAC ID: 6901082940 Enrollment ID: I20110509000796 |
| Provider Name | Amanda L Hearn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205109303 PECOS PAC ID: 1951546142 Enrollment ID: I20130315000409 |
| Provider Name | Cara R Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093057465 PECOS PAC ID: 6800038985 Enrollment ID: I20130820000885 |
| Provider Name | Mary B Buehler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093141087 PECOS PAC ID: 3375779150 Enrollment ID: I20131127000365 |
| Provider Name | Milicent Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487044244 PECOS PAC ID: 8426375544 Enrollment ID: I20150327002239 |
| Provider Name | Pamela Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164807186 PECOS PAC ID: 9830499110 Enrollment ID: I20151119000244 |
| Provider Name | Tracy W Rapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720451545 PECOS PAC ID: 4082914122 Enrollment ID: I20151123000776 |
| Provider Name | Leah B Gilliam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891037875 PECOS PAC ID: 1951540368 Enrollment ID: I20160113002065 |
| Provider Name | Scott S Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669954889 PECOS PAC ID: 4486907391 Enrollment ID: I20181023001651 |
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Henderson Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1132 Industrial Dr, Henderson, TN 38340 Phone: 731-983-3175 Fax: 731-983-3356 | |
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