Medina Family Medical Clinic Pc | |
209 Grace Cv Medina TN 38355-8785 | |
(731) 783-0400 | |
(731) 783-0402 |
Full Name | Medina Family Medical Clinic Pc |
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Speciality | Family Medicine |
Location | 209 Grace Cv, Medina, Tennessee |
Authorized Official Name and Position | Mechelle T Perry (OWNER) |
Authorized Official Contact | 7317830400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Medina Family Medical Clinic Pc Po Box 100 Medina TN 38355-0100 Ph: (731) 783-0400 | Medina Family Medical Clinic Pc 209 Grace Cv Medina TN 38355-8785 Ph: (731) 783-0400 |
NPI Number | 1609881150 |
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Provider Enumeration Date | 07/30/2006 |
Last Update Date | 01/19/2018 |
Medicare PECOS PAC ID | 9931161726 |
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Medicare Enrollment ID | O20041103000627 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609881150 | NPI | - | NPPES |
3727175 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Mechelle T Perry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225150667 PECOS PAC ID: 4486547908 Enrollment ID: I20040206000519 |
Provider Name | Darren R Perry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417982315 PECOS PAC ID: 6002878899 Enrollment ID: I20041109000170 |
Provider Name | Mechelle Taylor Moragne |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528093531 PECOS PAC ID: 7113980376 Enrollment ID: I20041109000195 |
Provider Name | Joel D Brunson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043519705 PECOS PAC ID: 1557546223 Enrollment ID: I20110421000766 |
Provider Name | Susan M Twilla |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235438664 PECOS PAC ID: 8820233141 Enrollment ID: I20130314000169 |
Provider Name | Cassidy Belew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548827223 PECOS PAC ID: 1759717168 Enrollment ID: I20200203002523 |
Provider Name | Roslin Marie Carlson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235700618 PECOS PAC ID: 2365847951 Enrollment ID: I20210819002034 |
First Choice Medical Care Of Medina, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Hwy 45 East, Medina, TN 38355 Phone: 731-267-0239 | |
South Gibson Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 589 Highway 45 Byp S, Medina, TN 38355 Phone: 713-462-0000 |