SAGE WELLNESS CLINIC, LLC (NPI# 1275152696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275152696 |
Entity Type | Organization |
Organization Name | SAGE WELLNESS CLINIC, LLC |
Practice Address |
14 Liberty Sq Sparta TN 38583-2044 |
Mailing Address |
Po Box 127 Monterey TN 38574-0127 |
Practice Telephone | 9312290552 |
Mailing Telephone | 9312290552 |
Enumeration Date | 2020-04-15 |
Last Update Date | 2020-04-15 |
Authorized Official Name | REE RENE SMITH (OWNER) |
Authorized Official Telephone | 9312290552 |
Authorized Official Credential | APRN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
14 LIBERTY SQ |
City | SPARTA |
State | TN |
Zip Code | 38583-2044 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538769047 | Results-ast Jv, LLC | Physical Therapist | 421 Sewell Road, Sparta, TN 38583 | 2020-10-26 |
1588282917 | Rock House Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 25 N Spring St, Sparta, TN 38583 | 2020-07-13 |
1881215333 | Nancy Marie Rutherford | Physical Therapist | 421 Sewell Drive, Sparta, TN 38583 | 2020-05-06 |
1942798210 | Oscar Dale Sims | Pharmacist | 202 Sam Walton Drive, Sparta, TN 38583 | 2018-04-23 |
1932622644 | Medicherla Shyam Sunder Kumar | Internal Medicine | 401 Sewell Road, Sparta, TN 38583 | 2017-07-25 |
1972852341 | Jtp Enterprises, LLC | Clinic/Center | 287 Turntable Rd., Sparta, TN 38583 | 2012-08-31 |
1154619898 | Abbie Howell | Pharmacist | 460 West Bockman Way, Sparta, TN 38583 | 2011-07-15 |
1164556759 | Leslie Ann Reagan | Pharmacist | 207 West Town Plaza, Sparta, TN 38583 | 2007-03-15 |
1497809875 | Waymon Haston | Dentist | 9-a Hampton Drive, Sparta, TN 38583 | 2007-01-22 |
1407920127 | Jeffry Alan Belknap | Internal Medicine | 809 W Bockman Way, Sparta, TN 38583 | 2006-11-17 |
Find all providers in zip 38583 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790386951 | Katherine Grace Dymacz | Nurse Practitioner | 376 Lafayette Rd Ste 101, Sparta, NJ 07871-3560 | 2020-11-04 |
1043790504 | Regional Services | Nurse Practitioner | 8520 Mo-14, Sparta, MO 65753 | 2018-08-15 |
1265957054 | Laura Allese Hall | Nurse Practitioner | 150 Sam Walton Dr Ste 600, Sparta, TN 38583-8814 | 2017-08-14 |
1649436965 | Sarah Catherine Sandgran | Nurse Practitioner | 26 Gail Ct Ste 2a, Sparta, NJ 07871-3487 | 2008-08-06 |
1548450349 | Bryan L. Logan | Nurse Practitioner | 155 Village Drive, Sparta, MO 65673 | 2007-07-27 |
1407968936 | Maria Haydon Buttner | Nurse Practitioner | 11 Centre Street, Theatre Center, Sparta, NJ 07871 | 2006-08-31 |
1003881244 | Deanne C Rieckenberg | Nurse Practitioner | 215 S Burns Ave, Sparta Medical Office, Sparta, IL 62286 | 2006-02-21 |
1356338982 | Jennifer L Hart | Nurse Practitioner | 11 Theatre Ctr, Sparta, NJ 07871-2433 | 2005-09-29 |
1942761929 | Kathleen Loyd | Nurse Practitioner | 150 Sam Walton Dr, Sparta, TN 38583-8815 | 2019-03-30 |
1780157313 | Judith Anne Connell | Nurse Practitioner | 25 Main St, Sparta, NJ 07871-1937 | 2019-01-07 |
Find all providers in SPARTA |
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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.