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301 Wolverine Trl Ste 201 Smyrna TN 37167-5656 | |
| (615) 768-5511 | |
| (615) 768-5519 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 301 Wolverine Trl Ste 201, Smyrna, Tennessee |
| Authorized Official Name and Position | Lucinda Motley (OWNER) |
| Authorized Official Contact | 6157685511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
301 Wolverine Trl Ste 201 Smyrna TN 37167-5656 Ph: (615) 768-5511 | 301 Wolverine Trl Ste 201 Smyrna TN 37167-5656 Ph: (615) 768-5511 |
| NPI Number | 1467015180 |
|---|---|
| Provider Enumeration Date | 04/18/2019 |
| Last Update Date | 07/02/2019 |
| Medicare PECOS PAC ID | 3072847813 |
|---|---|
| Medicare Enrollment ID | O20190627000996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467015180 | NPI | - | NPPES |
| 1523655 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lucinda Motley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417198292 PECOS PAC ID: 7719166289 Enrollment ID: I20110131000172 |
| Provider Name | Chelsea Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700517455 PECOS PAC ID: 2365824083 Enrollment ID: I20220727003677 |
| Provider Name | Norma Jean Smith Richcreek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063111029 PECOS PAC ID: 2466826318 Enrollment ID: I20230316001751 |
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