COVENANT MEDICAL GROUP INC (NPI# 1629266994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629266994 |
| Entity Type | Organization |
| Organization Name | COVENANT MEDICAL GROUP INC |
| Practice Address |
415 Henslee Dr Dickson TN 37055-2166 |
| Practice Telephone | 6154416140 |
| Practice Fax Number | 6154416190 |
| Mailing Telephone | 6154416140 |
| Mailing Fax Number | 6154416190 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2008-01-08 |
| Authorized Official Name | DR. WALTER STEPHENS (OWNER) |
| Authorized Official Telephone | 6154416140 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
415 HENSLEE DR |
| City | DICKSON |
| State | TN |
| Zip Code | 37055-2166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518955699 | Todd A Warren | Nurse Practitioner | 415 Henslee Dr, Dickson, TN 37055-2166 | 2005-10-12 |
| 1639644917 | Comprehensive Neurology Center, Pllc | Pain Medicine | 415 Henslee Dr, Dickson, TN 37055-2166 | 2018-10-12 |
| 1578930251 | Orthopaedic Specialists Pllc | Orthopaedic Surgery | 415 Henslee Dr, Dickson, TN 37055-2166 | 2015-08-28 |
| 1568492049 | Brandon Howard Downs | Orthopaedic Surgery | 415 Henslee Dr, Dickson, TN 37055-2166 | 2006-07-03 |
| 1497705040 | Horizon Orthopedics, LLC | Orthopaedic Surgery | 415 Henslee Dr, Dickson, TN 37055-2166 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406186 | Raven Julia Jackson | Dentist | 445 Tn-46 S, Dickson, TN 37055 | 2020-08-03 |
| 1336767839 | Logan Newman | Student in an Organized Health Care Education/Training Program | 102 Us70 East, Suite 2, Dickson, TN 37055 | 2020-07-10 |
| 1720575012 | Vb Tennessee I Pllc | Dentist | 2027 Thornton Dr, Dickson, TX 37055 | 2018-04-23 |
| 1376075358 | Sharon Elizabeth Sharber | Nurse Practitioner | 111 Highway 70 E Ste E, Dickson, TN 37055 | 2017-03-29 |
| 1992255921 | Karen Alonzo | Occupational Therapy Assistant | 312 N Charlotte St, Dickson, TN 37055 | 2016-10-13 |
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1760894398 | Joshua A. Vaughn | Physical Therapist | 766 Highway 46 South, Dickson, TN 37055 | 2014-06-02 |
| 1902217292 | Keith Payton | Dentist | 217 Highway 46 Ste D, Dickson, TN 37055 | 2014-05-08 |
| 1073953840 | John Harrison | Dentist | 134 Us-70, Dickson Pediatric Dentistry, Dickson, TN 37055 | 2013-06-26 |
| Find all providers in zip 37055 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285951095 | Perrigin Medical Pllc | Clinic/Center | 219 Church St, Dickson, TN 37055-1303 | 2010-05-03 |
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| 1366080582 | Matthew E. Schantz, M.d. | Clinic/Center | 206 S Military St Ste 1, Loretto, TN 38469-2101 | 2019-12-18 |
| 1114563749 | Step One Medical Associates PC | Clinic/Center | 4502 Bristol Hwy, Johnson City, TN 37601-2936 | 2019-11-19 |
| 1023665403 | Elite Healthcare, LLC | Clinic/Center | 117 N 3rd St, Kingston, TN 37763-2842 | 2019-08-21 |
| 1083266381 | Get Into Shape Md | Clinic/Center | 5803 Lee Hwy Ste 101, Chattanooga, TN 37421-3547 | 2019-07-16 |
| 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.