SUMMIT CONVENIENT CARE AT LEBANON LLC (NPI# 1568627271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568627271 |
| Entity Type | Organization |
| Organization Name | SUMMIT CONVENIENT CARE AT LEBANON LLC |
| Practice Address |
100 Physicians Way Suite 110 Lebanon TN 37090-8102 |
| Practice Telephone | 6154491100 |
| Practice Fax Number | 6154491150 |
| Mailing Telephone | 6154491100 |
| Mailing Fax Number | 6154491150 |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2010-05-20 |
| Authorized Official Name | GARY DUNCAN (VICE PRESIDENT) |
| Authorized Official Telephone | 6153725135 |
| Is Organization Subpart | Y |
| Parent Organization Name | HOSPITAL CORP LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1511412 | 05 | |
| TN | RR MEDICARE | DO3658 | 01 |
| TN | BCBS | 4214465 | 01 |
| Street Address |
100 PHYSICIANS WAY SUITE 110 |
| City | LEBANON |
| State | TN |
| Zip Code | 37090-8102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679570345 | Rhoda S Powers | Nurse Practitioner | 100 Physicians Way, Lebanon, TN 37090 | 2005-07-07 |
| 1982059317 | Lydia Moore | Nurse Practitioner | 100 Physicians Way, Suite 300, Lebanon, TN 37090-8102 | 2016-05-04 |
| 1962809129 | Premier Orthopaedics & Sports Medicine, Plc | Durable Medical Equipment & Medical Supplies | 100 Physicians Way, Suite 120, Lebanon, TN 37090-8102 | 2014-12-03 |
| 1043615644 | Kristina Moore | Physician Assistant | 100 Physicians Way, Suite 110, Lebanon, TN 37090-8102 | 2014-10-27 |
| 1386073674 | Stacey Atkins | Nurse Practitioner | 100 Physicians Way, Suite 250, Lebanon, TN 37090-8102 | 2013-11-06 |
| 1437584299 | Premier Orthopaedics & Sports Medicine, Plc | Durable Medical Equipment & Medical Supplies | 100 Physicians Way, Suite 110, Lebanon, TN 37090-8102 | 2013-09-11 |
| 1538407127 | Casey Paige Lewis | Pharmacist | 100 Physicians Way, Lebanon, TN 37090-8102 | 2013-01-16 |
| 1134471725 | Uap Lebanon Endo, LLC | Nurse Anesthetist, Certified Registered | 100 Physicians Way, Ste 340, Lebanon, TN 37090-8102 | 2012-10-08 |
| 1467737999 | Janet Daily | Nurse Practitioner | 100 Physicians Way, Suite 330, Lebanon, TN 37090-8102 | 2011-10-16 |
| 1023327814 | Kristy M Blaney | Registered Nurse | 100 Physicians Way, Suite 250, Lebanon, TN 37090-8102 | 2010-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376926840 | Kathryn Mccloud | Physical Therapist | 163 Business Park Drive, Lebanon, TN 37090 | 2015-07-02 |
| 1811380926 | Samantha Smith | Nurse Practitioner | 101 Physicians Way Ste 111, Lebanon, TN 37090 | 2015-03-13 |
| 1760575831 | Ronald Scott Forczek | Respiratory Therapist, Certified | 8265 Trousdale Ferry Pike, Lebanon, TN 37090 | 2006-10-02 |
| 1649271206 | Roy C. Terry | Orthopaedic Surgery | 101 Physicians Way, Ste. 111, Lebanon, TN 37090 | 2005-08-04 |
| 1285103689 | Jessica A Barron | Dermatology | 107 Glidepath Way, Lebanon, TN 37090 | 2018-11-15 |
| 1811109614 | Susan Anissa Hatcher | Occupational Therapy Assistant | 2215 Callis Rd, Lebanon, TN 37090 | 2007-05-04 |
| 1326030156 | Tennessee Orthopedics, P.C. | Orthopaedic Surgery | 101 Physicians Way, Ste. 111, Lebanon, TN 37090 | 2005-08-18 |
| 1154686673 | Stephanie Ruckman | Nurse Practitioner | 115 Moriah Dr, Lebanon, TN 37090-0731 | 2012-07-10 |
| 1801939798 | Prospect, Inc. | In Home Supportive Care | 960 Maddox Simpson Pkwy, Lebanon, TN 37090-0751 | 2007-02-14 |
| 1093262743 | Prospect, Incorporated | Day Training, Developmentally Disabled Services | 960 Maddox Simpson Pkwy, Lebanon, TN 37090-0751 | 2016-09-09 |
| Find all providers in zip 37090 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010338 | Lauren Crook | Nurse Practitioner | 1381 Fox Fire Ct, Lebanon, OH 45036-4032 | 2020-10-09 |
| 1417505058 | Tanya Dawn Viars | Nurse Practitioner | 754 East Main St, Lebanon, VA 24266-2426 | 2019-08-27 |
| 1053823377 | Allison Ickes | Nurse Practitioner | 900 Tuck Street; Mchs Lebanon / Heartland Care Partners, Lebanon, PA 17042-7446 | 2017-10-26 |
| 1124412879 | Samantha Meyer | Nurse Practitioner | 842 Carson Dr, Lebanon, OH 45036-1316 | 2015-03-20 |
| 1366687261 | Pamela S Lippitt | Nurse Practitioner | 944 Riley Wills Rd, Lebanon, OH 45036-9037 | 2008-12-05 |
| 1295950061 | Judith Ann Barberio | Nurse Practitioner | 7 Haytown Rd, Lebanon, NJ 08833-4009 | 2007-04-16 |
| 1437249372 | Anna Marie Dryer | Nurse Practitioner | 510 E. Hwy 32, Lebanon, MO 65536-5303 | 2006-10-13 |
| 1588755268 | Katherine A Tuthill | Nurse Practitioner | 18 Old Etna Road, Sleep Medicine, Lebanon, NH 03766 | 2006-09-27 |
| 1538101068 | Joy Bender Mcmurry | Nurse Practitioner | 1423 W. Baddour Parkway, Lebanon, TN 37088-1165 | 2006-06-11 |
| 1881672137 | Melynda Kaye Wallace | Nurse Practitioner | 252 Mechanic St, Lebanon, NH 03766-2613 | 2006-01-06 |
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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.