- Medicare Primary Care in Mountain City, TN

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is a medicare enrolled primary clinic (Clinic/center - Rural Health) in Mountain City, Tennessee. The current practice location for is 1901 S Shady St, Mountain City, Tennessee. For appointments, you can reach them via phone at (423) 727-1100. The mailing address for is 1901 S Shady St, Mountain City, Tennessee and phone number is (423) 727-1100.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1205846508. 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 (423) 727-1100.

Contact Information

1901 S Shady St
Mountain City
TN 37683-2021
(423) 727-1100
(423) 727-1105

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location1901 S Shady St, Mountain City, Tennessee
Authorized Official Name and PositionDwayne Taylor (CEO)
Authorized Official Contact4235421333
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

1901 S Shady St
Mountain City
TN 37683-2021

Ph: (423) 727-1100
1901 S Shady St
Mountain City
TN 37683-2021

Ph: (423) 727-1100

NPI Details:

NPI Number1205846508
Provider Enumeration Date08/09/2006
Last Update Date08/12/2024

Medicare PECOS Information:

Medicare PECOS PAC ID6002726718
Medicare Enrollment IDO20040415001070

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205846508NPI-NPPES
3278673MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
261QR1300XClinic/center - Rural Health (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameSusanne M Shine
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659337772
PECOS PAC ID: 0345224549
Enrollment ID: I20040615001650
Provider NameJames W Shine
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1194781724
PECOS PAC ID: 2567446206
Enrollment ID: I20040617001588
Provider NameRuth D Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316272453
PECOS PAC ID: 8325181720
Enrollment ID: I20100208000358
Provider NameDevapiran Jaishankar
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1225038490
PECOS PAC ID: 7618002080
Enrollment ID: I20100324000509
Provider NameKanishka Chakraborty
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1992993760
PECOS PAC ID: 9335397447
Enrollment ID: I20120914000515
Provider NameMegan D Johnson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457644254
PECOS PAC ID: 0345462941
Enrollment ID: I20141115000312
Provider NameJamie E Carnell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346632783
PECOS PAC ID: 2668792003
Enrollment ID: I20150526001882
Provider NameLindsey Debord Yoggerst
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366962631
PECOS PAC ID: 7911270103
Enrollment ID: I20180907002853
Provider NameSakshi Singal
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1356758239
PECOS PAC ID: 1355560863
Enrollment ID: I20191217002010
Provider NameAlina Bhat
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1871907147
PECOS PAC ID: 2769737121
Enrollment ID: I20211025001927
Provider NameSuzan Page
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740716927
PECOS PAC ID: 5991074619
Enrollment ID: I20211208003089
Provider NameDanielle S Giles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750005492
PECOS PAC ID: 9739556440
Enrollment ID: I20221109003486
Provider NameJamie Gail Mcnutt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437874294
PECOS PAC ID: 4082050968
Enrollment ID: I20240314000110
Provider NameHenry Renick Hartsoe
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609455880
PECOS PAC ID: 0941748743
Enrollment ID: I20240812001882
Provider NameThomas Fitzgerald
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1336134766
PECOS PAC ID: 2567567126
Enrollment ID: I20241008000221
Provider NameHesham Hazin
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1235369307
PECOS PAC ID: 0840344966
Enrollment ID: I20241016001853
Provider NameMatthew Joseph Rendo
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1700246394
PECOS PAC ID: 5193088003
Enrollment ID: I20241204004706

Reviews and Comments


Clinic/Center in Mountain City, TN


Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1901 S Shady St Ste A, Mountain City, TN 37683
Phone: 423-727-1103    Fax: 423-727-1140

Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1901 S Shady Street, Mountain City, TN 37683
Phone: 423-727-1150    Fax: 423-727-1152
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

Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 1901 S Shady St, Mountain City, TN 37683
Phone: 423-727-1103    Fax: 423-727-1140

Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 100 Kellogg Dr, Mountain City, TN 37683
Phone: 423-460-3232    Fax: 423-460-3234

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.