| Livesay Family Medicine, Pc | |
|
200 Nettleton Rd Ste 1 Harrogate TN 37752-8225 | |
| (423) 419-5550 | |
| (423) 419-5551 |
| Full Name | Livesay Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 200 Nettleton Rd Ste 1, Harrogate, Tennessee |
| Authorized Official Name and Position | Tom D. Livesay (OWNER) |
| Authorized Official Contact | 4234195550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livesay Family Medicine, Pc 200 Nettleton Rd Ste 1 Harrogate TN 37752-8225 Ph: (423) 419-5550 | Livesay Family Medicine, Pc 200 Nettleton Rd Ste 1 Harrogate TN 37752-8225 Ph: (423) 419-5550 |
| NPI Number | 1932488327 |
|---|---|
| Provider Enumeration Date | 08/16/2011 |
| Last Update Date | 03/12/2021 |
| Medicare PECOS PAC ID | 3678744430 |
|---|---|
| Medicare Enrollment ID | O20110927000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932488327 | NPI | - | NPPES |
| 1932488327 | Other | VA | VA MEDICAID |
| 1525171 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Tommy Livesay |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154581437 PECOS PAC ID: 0648441121 Enrollment ID: I20110927000767 |
| Provider Name | Ashley Nicole Smallwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699313528 PECOS PAC ID: 9739517368 Enrollment ID: I20200314000007 |
| Provider Name | Ashley N Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356781900 PECOS PAC ID: 8527200245 Enrollment ID: I20210716002264 |
Hearland Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 Beech Street, Suite 1, Harrogate, TN 37752 Phone: 423-626-7297 Fax: 423-851-4704 | |
Family Medical Clinic Of Harrogate, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 170 Beech St Ste 1, Harrogate, TN 37752 Phone: 423-869-3684 Fax: 423-869-5460 | |
Harrogate Family & Health Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 169 Westmoreland St Lowr Level, Harrogate, TN 37752 Phone: 423-869-0004 Fax: 423-869-5555 |