CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC (NPI# 1841311529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841311529 |
| Entity Type | Organization |
| Organization Name | CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC |
| Other Organization Name | LAKE COUNTY PRIMARY CARE |
| Practice Address |
710 Carl Perkins Pkwy Tiptonville TN 38079 |
| Practice Telephone | 7312536690 |
| Practice Fax Number | 7312536692 |
| Mailing Telephone | 7312536690 |
| Mailing Fax Number | 7312536692 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2012-11-06 |
| Authorized Official Name | MRS. AMBER MARIE ISBELL (FINANCIAL OFFICER) |
| Authorized Official Telephone | 7312536690 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI DR. CAROL GUESS | 1992848816 | 01 | |
| TN | 444-7958 | 05 |
| Other Name | Type Code |
|---|---|
| Lake County Primary Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593944 | Citizens of Lake County for Health Care Inc | Clinic/Center | 321 E Harper St, Troy, TN 38260 | 2020-06-23 |
| 1851697817 | Citizens of Lake County for Health Care Inc | Clinic/Center | 130 N Main St, Ridgely, TN 38080-1317 | 2011-02-08 |
| Street Address |
710 CARL PERKINS PKWY |
| City | TIPTONVILLE |
| State | TN |
| Zip Code | 38079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023033073 | Fernando Cardenas Lagrimas | Specialist | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2006-07-12 |
| 1285266676 | Terra Micah King | Nurse Practitioner | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2020-02-04 |
| 1609383082 | Michael Lynn Hall | Nurse Practitioner | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2018-01-06 |
| 1457789380 | Courtney Faught | Nurse Practitioner | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2013-11-01 |
| 1275873424 | Lake County Primary Care | Clinic/Center | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2013-02-26 |
| 1093073280 | James Allen Oaks | Internal Medicine | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2012-04-25 |
| 1164745998 | Deborah S Nale | Nurse Practitioner | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2010-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356893044 | John Mancell | Pharmacist | 650 Carl Perkins Pkwy, Tiptonville, TN 38079 | 2016-10-27 |
| 1982048757 | Astin Berry | Physical Therapy Assistant | 3195 Cates Landing Rd N, Tiptonville, TN 38079 | 2013-04-24 |
| 1821383670 | Roberson Rike Clinic | Nurse Practitioner | 768 Everett St., Tiptonville, TN 38079 | 2011-06-09 |
| 1366648735 | Amanda Collins | Physician Assistant | Northwest Corrections, Tiptonville, TN 38079 | 2007-06-22 |
| 1710011994 | Sandra Lynnette Smith | Registered Nurse | 400 Hwy 78 S, Tiptonville, TN 38079 | 2007-03-16 |
| 1871643031 | State of Tennessee | Public Health or Welfare | 400 Hwy 78 South, Tiptonville, TN 38079 | 2007-01-11 |
| 1508807736 | Daniel W. Bruce | Legal Medicine | 708 Everett St, Tiptonville, TN 38079 | 2006-06-09 |
| 1770012676 | Main Street Family Care Pllc | Clinic/Center | 211 Church St, Tiptonville, TN 38079-1109 | 2017-06-06 |
| 1689914632 | Kerri A Ervin | Nurse Practitioner | 211 Church St, Tiptonville, TN 38079-1109 | 2013-02-27 |
| 1366614588 | Blue Ribbon Dental Center LLC | Health Maintenance Organization | 211 Church St, Tiptonville, TN 38079-1109 | 2008-03-27 |
| Find all providers in zip 38079 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275873424 | Lake County Primary Care | Clinic/Center | 710 Carl Perkins Pkwy, Tiptonville, TN 38079-1678 | 2013-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525809 | Christ Community Health Services, Inc | Clinic/Center | 4350 Chuck Ave, Memphis, TN 38118-4076 | 2020-07-08 |
| 1730707621 | Christ Community Health Services, Inc. | Clinic/Center | 3206 Poplar Ave, Memphis, TN 38111-3502 | 2020-07-08 |
| 1003442112 | Christ Commuity Health Services Inc | Clinic/Center | 3360 S 3rd St, Memphis, TN 38109-2944 | 2020-03-20 |
| 1689160939 | Maury Regional Hospital | Clinic/Center | 98 Experiment Station Lane, Columbia, TN 38401-4700 | 2018-07-10 |
| 1194245399 | United Neighborhood Health Services, Inc. | Clinic/Center | 442 Metroplex Dr Ste 200, Nashville, TN 37211-3112 | 2017-06-20 |
| 1659745354 | Memphis Health Center, Inc. | Clinic/Center | 4250 Faronia Rd Ste 2a, Memphis, TN 38116-6527 | 2015-11-18 |
| 1639546187 | United Neighborhood Health Services, Inc. | Clinic/Center | 3904 Gallatin Pike, Nashville, TN 37216 | 2015-08-31 |
| 1790170389 | Maury Regional Hospital | Clinic/Center | 854 W James M Campbell Blvd Ste 301, Columbia, TN 38401-4659 | 2015-04-01 |
| 1285999128 | United Neighborhood Health Services, Inc | Clinic/Center | 401 Walton Ln, Nashville, TN 37216-1018 | 2012-07-06 |
| 1891058848 | United Neighborhood Health Services, Inc | Clinic/Center | 1900 Hobson Pike, Antioch, TN 37013-2421 | 2012-06-23 |
| Find all providers with the same taxonomy | ||||
| City | TIPTONVILLE |
| Zip Code | 38079 |
Please comment or provide details below to improve the information on CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC.
| 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.