CUMBERLAND GAP MEDICAL (NPI# 1336563204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336563204 |
| Entity Type | Organization |
| Organization Name | CUMBERLAND GAP MEDICAL |
| Practice Address |
502 W Central Ave Suite 2 La Follette TN 37766-3400 |
| Practice Telephone | 4232019799 |
| Practice Fax Number | 4234378162 |
| Mailing Telephone | 4232019799 |
| Mailing Fax Number | 4234378162 |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |
| Authorized Official Name | AMANDA SUE COLLINS (NURSE PRACTITIONER) |
| Authorized Official Telephone | 4232019799 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000016605 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
502 W CENTRAL AVE SUITE 2 |
| City | LA FOLLETTE |
| State | TN |
| Zip Code | 37766-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215971379 | Kathy M Jackson | Family Medicine | 502 W Central Ave, La Follette, TN 37766-3400 | 2006-06-16 |
| 1891336285 | L & M Inc. | Pharmacy | 502 W Central Ave, La Follette, TN 37766-3400 | 2019-10-07 |
| 1215128004 | Marcus Fayne Cole Jr. | Pharmacist | 502 W Central Ave, La Follette, TN 37766-3400 | 2007-08-06 |
| 1225182199 | Rhonda S. Cross | Social Worker | 502 W Central Ave, La Follette, TN 37766-3400 | 2007-01-22 |
| 1346251998 | Riggs Drug Store | Pharmacy | 502 W Central Ave, La Follette, TN 37766-3400 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819914 | Legal Medicine | Nurse Practitioner | 100 South 5th Street, Lafollette, TN 37766 | 2019-03-04 |
| 1306329818 | Kayla Ward | Nurse Practitioner | 617 E Central Ave, La Follette, TN 37766 | 2018-09-11 |
| 1740588920 | Campbell County Walk In Clinic LLC | Family Medicine | 2301 Jacksboro Pkie, Lafollette, TN 37766 | 2011-03-11 |
| 1992001853 | Complete Rural Healthcare and Medical Center Pllc | Specialist | 2146 Jacksboro Pike Suite C, Lafollette, TN 37766 | 2011-02-09 |
| 1821211582 | Bill R Fannon Jr. | Pharmacist | 502 West Central Ave, La Follette, TN 37766 | 2007-04-11 |
| 1437272606 | Kelly B Wells | Pharmacist | 502 West Central Avenue, La Follette, TN 37766 | 2007-04-10 |
| 1548386899 | Gerald A Troutman | Dentist | 109 East Beech Street, Lafollette, TN 37766 | 2007-03-21 |
| 1437280815 | Susan Rebecca Mills | Nurse Practitioner | 2221 Jacksboro Pike Ste C4, La Follette, TN 37766 | 2007-03-08 |
| 1699844399 | County of Campbell | Ambulance | 136 North Massachusetts Ave, Lafollette, TN 37766 | 2006-11-07 |
| 1336230465 | George O'neal Vinsant | Surgery | 919 E. Central Avenue, Suite 201, Lafollette, TN 37766 | 2006-09-27 |
| Find all providers in zip 37766 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396375754 | Hannah Deshea Daugherty | Nurse Practitioner | 2288 Long Hollow Rd, La Follette, TN 37766-5841 | 2020-01-23 |
| 1306329818 | Kayla Ward | Nurse Practitioner | 617 E Central Ave, La Follette, TN 37766 | 2018-09-11 |
| 1780122671 | Pamela Cavins | Nurse Practitioner | 412 E Central Ave, La Follette, TN 37766-2530 | 2017-02-10 |
| 1457696502 | Lafollette Wellness Center | Nurse Practitioner | 2212 Jacksboro Pike, La Follette, TN 37766-2903 | 2012-11-30 |
| 1104186030 | Debra Verna | Nurse Practitioner | 504 S Tennessee Ave, La Follette, TN 37766-3649 | 2012-05-25 |
| 1659477032 | Jack Thomas Mcafee | Nurse Practitioner | 136 Davis Ln, La Follette, TN 37766-3118 | 2006-09-15 |
| 1487270641 | Sheena L Byrd | Nurse Practitioner | 402 E Central Ave, La Follette, TN 37766-2530 | 2020-06-23 |
| 1588154009 | Megan Raquel Rielly | Nurse Practitioner | 402 E Central Ave, La Follette, TN 37766-2530 | 2018-05-10 |
| 1336519842 | Heather Whittemore | Nurse Practitioner | 402 E Central Ave, La Follette, TN 37766-2530 | 2015-09-28 |
| 1932581667 | Deborah Lynn Russell | Nurse Practitioner | 130 Independence Ln, La Follette, TN 37766-3073 | 2015-06-18 |
| Find all providers in LA FOLLETTE | ||||
| City | LA FOLLETTE |
| Zip Code | 37766 |
Please comment or provide details below to improve the information on CUMBERLAND GAP MEDICAL.
| 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.