IMPACT HEALTHCARE PLLC (NPI# 1487185153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487185153 |
| Entity Type | Organization |
| Organization Name | IMPACT HEALTHCARE PLLC |
| Practice Address |
37 Sandstone Cir Ste 92 Jackson TN 38305-2089 |
| Mailing Address |
2131 Military St S Hamilton AL 35570-6651 |
| Practice Telephone | 7314454879 |
| Mailing Telephone | 2059215556 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-28 |
| Authorized Official Name | BRENT EDGEWORTH BOYETT (SOLE MBR) |
| Authorized Official Telephone | 2059215556 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639656986 | Impact Healthcare Pllc | Family Medicine | 801 Hill St, Springfield, TN 37172-2951 | 2018-07-19 |
| Street Address |
37 SANDSTONE CIR STE 92 |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-2089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366436669 | Madison Clinic Corp Dba Jackson Pediatric Center | Pediatrics | 37 Sandstone Cir, Jackson, TN 38305-2073 | 2005-09-01 |
| 1063047652 | Taylor Ross O'connor | Social Worker | 37 Sandstone Cir, Jackson, TN 38305-2089 | 2020-03-04 |
| 1003355652 | Pathway Healthcare Tennessee LLC | Anesthesiology | 37 Sandstone Cir, Suite 92, Jackson, TN 38305-2089 | 2017-02-15 |
| 1871521237 | Stephen C. Goodwin | Specialist | 37 Sandstone Cir, Jackson, TN 38305-2073 | 2006-06-28 |
| 1477598134 | Jackson Home Care Services LLC | Home Health | 37 Sandstone Cir, Ste 201, Jackson, TN 38305-2073 | 2006-06-18 |
| 1104816990 | Bola Adamolekun | Psychiatry & Neurology | 37 Sandstone Cir, Jackson, TN 38305-2073 | 2005-10-24 |
| 1689662777 | Alice Roark Mckee | Family Medicine | 37 Sandstone Cir, Jackson, TN 38305-2073 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1487179156 | Pathway Healthcare - Jackson, Ms, LLC | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2017-08-03 |
| 1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811508765 | Pw-hospital Bridge Services, LLC | Family Medicine | 801 Hill St Ste A, Springfield, TN 37172-2951 | 2020-08-13 |
| 1285268243 | Alpha Medical Center, LLC | Family Medicine | 1421 W Baddour Pkwy Ste A, Lebanon, TN 37087-2652 | 2020-02-28 |
| 1770133597 | Renewal Healthcare | Family Medicine | 7035 Middlebrook Pike, Knoxville, TN 37909 | 2019-09-13 |
| 1518425941 | Hamm, Blackstock & Stern, Pllc | Family Medicine | 2135 Dalkeith Dr, Germantown, TN 38139-3407 | 2019-03-05 |
| 1336636158 | Foundation Medical, Inc. | Family Medicine | 1730 Old Gray Station Rd, Johnson City, TN 37615-3869 | 2018-04-17 |
| 1770080632 | East Tennessee Addiction Specialists | Family Medicine | 2022 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2018-04-09 |
| 1912418435 | Sunrise Medical Associates Inc. | Family Medicine | 9 Worth Cir Ste 100, Johnson City, TN 37601-4358 | 2017-10-24 |
| 1851810774 | Physician Hope and Wellness Center | Family Medicine | 1915c Church St, Nashville, TN 37203-2203 | 2017-09-12 |
| 1619409489 | Watauga Recovery Center Greeneville | Family Medicine | 819 W Church Street, Greeneville, TN 37745 | 2017-03-31 |
| 1568913663 | Watauga Recovery Center Newport PC | Family Medicine | 330 Heritage Blvd, Newport, TN 37821-4257 | 2016-10-24 |
| Find all providers with the same taxonomy | ||||
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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.