COFFEE COUNTY PHYSICIAN GROUP PC (NPI# 1437164878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437164878 |
| Entity Type | Organization |
| Organization Name | COFFEE COUNTY PHYSICIAN GROUP PC |
| Practice Address |
481 Interstate Dr Manchester TN 37355-3108 |
| Practice Telephone | 9317286354 |
| Practice Fax Number | 9317286354 |
| Mailing Telephone | 9317286354 |
| Mailing Fax Number | 9317286354 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT J COUCH (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9317286354 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0000000016 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3727643 | 05 |
| Street Address |
481 INTERSTATE DR |
| City | MANCHESTER |
| State | TN |
| Zip Code | 37355-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013969179 | Coffee Medical Group LLC | General Acute Care Hospital | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-05-17 |
| 1447704846 | Bledsoe Falls Emergency Physicians LLC | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2016-08-15 |
| 1972724722 | Coffee County Hospital Group Inc | Medicare Defined Swing Bed Unit | 481 Interstate Dr, Manchester, TN 37355-3108 | 2007-05-01 |
| 1235145459 | James M Reed | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-31 |
| 1356356281 | Isaac H Stovall | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-29 |
| 1215941646 | Coffee County Hospital Group, Inc | General Acute Care Hospital | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-29 |
| 1467495119 | Marsha L Marlin | Nurse Anesthetist, Certified Registered | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857126 | Ashley Harmon Layne | Speech-Language Pathologist | 205 S Woodland St, Manchester, TN 37355 | 2018-07-17 |
| 1760996771 | Quad/med, LLC | Clinic/Center | 227 Monogard Rd, Manchester, TN 37355 | 2017-11-29 |
| 1881108157 | Sarabeth Seagreaves | Specialist/Technologist | 1700 Summer St Apt A36, Manchester, TN 37355 | 2017-11-25 |
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1316361561 | Charlotte Gibbs | Counselor | 482 Interstate Dr Ste D, Manchester, TN 37355 | 2014-02-08 |
| 1205258191 | Aleene Marie Falk | Social Worker | 218 Forrestwood Drive, Manchester, TN 37355 | 2014-01-10 |
| 1790067429 | Reda Lynn Lawson | Registered Nurse | 800 Parks Street, Manchester, TN 37355 | 2011-09-20 |
| 1912294117 | Patricia Beth Elliott | Nurse Practitioner | 804 Keylon Street, Manchester, TN 37355 | 2011-07-08 |
| 1427241421 | Kimberly D. Mathis | Nurse Practitioner | 1600 Mcarthur Street, Manchester, TN 37355 | 2007-08-22 |
| 1982761441 | Richard Eugene Fishbein | Orthopaedic Surgery | 102 East High Street, Manchester, TN 37355 | 2007-01-03 |
| Find all providers in zip 37355 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538140405 | Thomas Joseph Kafka | Emergency Medicine | Regional Medical Center, 709 West Main St., Manchester, IA 52057 | 2005-11-08 |
| 1831250943 | Patrick W Lee | Emergency Medicine | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-12-12 |
| 1619038023 | Granite State Emergency Physicians PC | Emergency Medicine | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-12-12 |
| 1235145459 | James M Reed | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-31 |
| 1356356281 | Isaac H Stovall | Emergency Medicine | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-07-29 |
| 1326073669 | Delaware County Memorial Hospital | Emergency Medicine | 709 W Main St, Manchester, IA 52057-1526 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992182224 | Steven T. Haywood | Emergency Medicine | 1120 Skyline Dr, Johnson City, TN 37604-3779 | 2015-05-06 |
| 1003173923 | Harold Earl Smith | Emergency Medicine | 2277 Stewarts Ferry Pike, Hermitage, TN 37076-3902 | 2012-04-17 |
| 1942538459 | Michael Alan Dorrity | Emergency Medicine | 2952 Gardens Way, Memphis, TN 38111-2647 | 2009-11-20 |
| 1730322389 | James Robert Davenport | Emergency Medicine | 209 Light Hall, Nashville, TN 37212 | 2009-04-13 |
| 1598938060 | William John Heerman | Emergency Medicine | Vanderbilt Medical Center 1215 21st Ave S, 7th Floor, Mce, Suite 2, North Tower, Nashville, TN 37232-0001 | 2008-04-07 |
| 1669556148 | Adejoke Foluke Aina-babalola | Emergency Medicine | 6716 Nolensville Pike, Suite 240, Brentwood, TN 37027-8805 | 2006-10-24 |
| 1003912148 | Richard W. Babin | Emergency Medicine | 506 S Yates Rd, Memphis, TN 38120-2436 | 2006-09-16 |
| 1679502314 | Meifung Kerley | Emergency Medicine | Lamont Street, Mountain Home, TN 37684 | 2006-07-03 |
| 1376579730 | Douglas Wister Ligon | Emergency Medicine | 4895 East Main St, Ste A, Erin, TN 37061 | 2006-06-25 |
| 1518912195 | Ralf Joffe | Emergency Medicine | 522 Treyburn Dr, Knoxville, TN 37934-0899 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 37355 |
Please comment or provide details below to improve the information on COFFEE COUNTY PHYSICIAN GROUP 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.