Longevity Clinical Ltc Associates Of Tennessee, Pllc is a medicare enrolled primary clinic (Family Medicine - Geriatric Medicine) in Red Boiling Springs, Tennessee. The current practice location for Longevity Clinical Ltc Associates Of Tennessee, Pllc is 309 Main St, Red Boiling Springs, Tennessee. For appointments, you can reach them via phone at
(615) 699-2238. The mailing address for Longevity Clinical Ltc Associates Of Tennessee, Pllc is 11780 Us Highway 1 Ste N107, North Palm Beach, Florida and phone number is (561) 815-2427.
Longevity Clinical Ltc Associates Of Tennessee, Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1326878299. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(615) 699-2238.
Primary Care Clinic Profile
| Full Name | Longevity Clinical Ltc Associates Of Tennessee, Pllc |
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| Speciality | Family Medicine |
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| Location | 309 Main St, Red Boiling Springs, Tennessee |
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| Authorized Official Name and Position | Diane Vincur (PRACTICE MANAGER) |
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| Authorized Official Contact | 5618152427 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Longevity Clinical Ltc Associates Of Tennessee, Pllc
11780 Us Highway 1 Ste N107
North Palm Beach
FL 33408-3007
Ph: (561) 815-2427 | Longevity Clinical Ltc Associates Of Tennessee, Pllc
309 Main St
Red Boiling Springs
TN 37150-2149
Ph: (615) 699-2238 |
NPI Details:
| NPI Number | 1326878299 |
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| Provider Enumeration Date | 08/06/2024 |
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| Last Update Date | 08/06/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 3779019146 |
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| Medicare Enrollment ID | O20241209002269 |
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Medical Identifiers
Medical identifiers for Longevity Clinical Ltc Associates Of Tennessee, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1326878299 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Longevity Clinical Ltc Associates Of Tennessee, Pllc acts as a billing entity for following providers:
| Provider Name | Kristina Michelle Rodgers |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1750052072
PECOS PAC ID: 5496144883
Enrollment ID: I20211104002215 |
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