COVENANT FAMILY PRACTICE, PC (NPI# 1225073166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225073166 |
| Entity Type | Organization |
| Organization Name | COVENANT FAMILY PRACTICE, PC |
| Practice Address |
1000 Highway 76 Clarksville TN 37043-8405 |
| Mailing Address |
Po Box 30459 Clarksville TN 37040-0008 |
| Practice Telephone | 9312458000 |
| Practice Fax Number | 9312450605 |
| Mailing Telephone | 9312458000 |
| Mailing Fax Number | 9312450605 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | DR. ROBERT ALAN WILSON (PRESIDENT) |
| Authorized Official Telephone | 9312451150 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TN BCBS | 4062086 | 01 |
| TN | 3718348 | 05 |
| Street Address |
1000 HIGHWAY 76 |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37043-8405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902465669 | Stephanie Lee Byard | Physician Assistant | 1000 Highway 76, Clarksville, TN 37043-8405 | 2019-06-06 |
| 1083126106 | Shannon Elizabeth Keller | Physician Assistant | 1000 Highway 76, Clarksville, TN 37043-8405 | 2017-10-30 |
| 1265738819 | Robert Niemann | Nurse Practitioner | 1000 Highway 76, Clarksville, TN 37043-8405 | 2011-01-31 |
| 1821392499 | Sabrina Cook | Nurse Practitioner | 1000 Highway 76, Clarksville, TN 37043-8405 | 2010-12-22 |
| 1649574211 | Covenant Family Practice | Clinic/Center | 1000 Highway 76, Clarksville, TN 37043-8405 | 2010-12-22 |
| 1528361730 | Covenant Family Practice | Clinic/Center | 1000 Highway 76, Clarksville, TN 37043-8405 | 2010-12-09 |
| 1588895635 | Anita Kline Taylor | Physician Assistant | 1000 Highway 76, Clarksville, TN 37043-8405 | 2009-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164982443 | Compassion Care Clinic | Family Medicine | 2269 Wilma Rudolph Blvd Ste 106, Clarksville, TN 37040-8416 | 2019-03-22 |
| 1427517986 | Garry Henderson Lovins | Family Medicine | 5914 Perfect Calm Ct, Clarksville, MD 21029-1259 | 2019-03-14 |
| 1962944686 | Urgent Care Hillcrest LLC | Family Medicine | 230 Hillcrest Dr, Clarksville, TN 37043-6520 | 2016-11-11 |
| 1356736854 | John Williams Ross | Family Medicine | 1492 Tiny Town Rd Ste A1-a2, Clarksville, TN 37042-7873 | 2015-04-01 |
| 1104253327 | Medical Direct Care, Plc | Family Medicine | 190 Hatcher Lane, Suite B, Clarksville, TN 37040 | 2013-10-02 |
| 1215364633 | America Cares Trust, Inc | Family Medicine | 647 Dunlop Ln Ste 102, Clarksville, TN 37040-5165 | 2013-09-30 |
| 1790055747 | Care for Your Health, Inc | Family Medicine | 12140 Flowing Water Trl, Clarksville, MD 21029-1682 | 2012-01-09 |
| 1790916690 | Patricia Lee Isaacs | Family Medicine | 2051 Clevidence Blvd Ste 1, Clarksville, IN 47129-2278 | 2009-07-27 |
| 1316120280 | Kenneth Lee Hershberger | Family Medicine | 309 Archer Dr, Clarksville, MI 48815-9789 | 2007-12-13 |
| 1003013160 | William P. Grabenstein | Family Medicine | 1822 Memorial Dr, Clarksville, TN 37043-4605 | 2007-06-29 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37043 |
Please comment or provide details below to improve the information on COVENANT FAMILY PRACTICE, PC.
| 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.