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100 Kellogg Dr Mountain City TN 37683-4077 | |
(423) 460-3232 | |
(423) 460-3234 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 Kellogg Dr, Mountain City, Tennessee |
Authorized Official Name and Position | Kimberly Kay Kleine (OWNER/FNP) |
Authorized Official Contact | 4234603232 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 Kellogg Dr Mountain City TN 37683-4077 Ph: (423) 460-3232 | 100 Kellogg Dr Mountain City TN 37683-4077 Ph: (423) 460-3232 |
NPI Number | 1548886385 |
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Provider Enumeration Date | 06/17/2020 |
Last Update Date | 11/04/2024 |
Medicare PECOS PAC ID | 0345665006 |
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Medicare Enrollment ID | O20200729001694 |
Identifier | Type | State | Issuer |
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1548886385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Kimberly Kleine |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962979617 PECOS PAC ID: 4880932300 Enrollment ID: I20190207002921 |
Donald F Tarr Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4200 Cold Springs Rd, Mountain City, TN 37683 Phone: 423-727-7743 Fax: 423-727-5509 | |
Donald R Walters Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 N Church St, Mountain City, TN 37683 Phone: 423-727-7711 Fax: 423-727-0209 | |