PROVIDENCE FAMILY MEDICINE, PLLC (NPI# 1376722546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376722546 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE FAMILY MEDICINE, PLLC |
| Practice Address |
1210 Briarville Rd Bldg E Madison TN 37115-5136 |
| Practice Telephone | 6158608182 |
| Practice Fax Number | 6158608184 |
| Mailing Telephone | 6158608182 |
| Mailing Fax Number | 6158608184 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2008-10-21 |
| Authorized Official Name | MRS. WENDY G MYLES (OFFICE MANAGER) |
| Authorized Official Telephone | 6158608182 |
| Authorized Official Credential | RMA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
37235 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI GROUP | 1376722546 | 01 |
| Street Address |
1210 BRIARVILLE RD BLDG E |
| City | MADISON |
| State | TN |
| Zip Code | 37115-5136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841282654 | Cathy L Hammond-moulton | Family Medicine | 1210 Briarville Rd Bldg E, Madison, TN 37115-5136 | 2005-08-17 |
| 1831378009 | Robinson Family Medicine,llc | Clinic/Center | 1210 Briarville Rd Bldg E, Madison, TN 37115-5136 | 2007-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
| 1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
| 1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
| 1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
| 1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
| 1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
| 1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
| 1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
| Find all providers in zip 37115 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1669918843 | All About You Healthcare LLC | Clinic/Center | 342 E Old Hickory Blvd, Madison, TN 37115-3937 | 2017-01-12 |
| 1548713332 | Wellness for Life | Clinic/Center | 630 Broadway St Ste 2a, Madison, IN 47250-3310 | 2016-07-27 |
| 1871863050 | Patrick J Oneill M.d., P.C. | Clinic/Center | 104 Spenryn Dr, Madison, AL 35758-1890 | 2012-01-05 |
| 1003191867 | Gluckstadt Special Care Clinic | Clinic/Center | 1716 Highway 51 Ste M, Madison, MS 39110-5020 | 2011-10-12 |
| 1104071836 | W Kevin Britt M.d. LLC | Clinic/Center | 1801 Clifty Drive, Madison, IN 47250-1627 | 2008-11-21 |
| 1366057986 | Avalon Family Care LLC | Clinic/Center | 540 Hughes Rd Ste 4, Madison, AL 35758-8959 | 2020-09-10 |
| 1447868757 | Advent Health LLC | Clinic/Center | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2020-07-22 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.