PREFERRED FAMILY MEDICAL CARE LLC (NPI# 1699188029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699188029 |
| Entity Type | Organization |
| Organization Name | PREFERRED FAMILY MEDICAL CARE LLC |
| Practice Address |
9026 Hiwassee St Ne Charleston TN 37310-5305 |
| Mailing Address |
9026 Hiwassee Street Ne Po Box 15 Charleston TN 37310 |
| Practice Telephone | 4236653666 |
| Practice Fax Number | 4235846747 |
| Mailing Telephone | 4236653666 |
| Mailing Fax Number | 4235846747 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2020-03-02 |
| Authorized Official Name | MR. KEITH L KIDD (CEO) |
| Authorized Official Telephone | 4236653666 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q007277 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9029 Hiwassee St Ne, Charleston, TN 37310 | 4236659026 |
| Street Address |
9026 HIWASSEE ST NE |
| City | CHARLESTON |
| State | TN |
| Zip Code | 37310-5305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811168941 | Keith L Kidd | Nurse Practitioner | 9026 Hiwassee St Ne, Charleston, TN 37310-5305 | 2008-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770863698 | Jeremy Swallows | Pharmacist | 845 Moore Rd Nw, Charleston, TN 37310-5010 | 2011-08-23 |
| 1376789339 | Vickie Darlene Smeltzer | Registered Nurse | 190 Moore Circle Rd Nw, Charleston, TN 37310-5026 | 2008-12-22 |
| 1942518287 | Eugene Baker | Pharmacist | 155 Jessie Ln Nw, Charleston, TN 37310-5119 | 2010-09-21 |
| 1184038762 | Danny Ray Nelson | Nurse Practitioner | 424 Wylou Dr Nw, Charleston, TN 37310-5179 | 2014-06-11 |
| 1952727976 | Thomas Odom | Respiratory Therapist, Registered | 117 Marina Dr Nw, Charleston, TN 37310-5217 | 2014-03-14 |
| 1689673105 | Kavin J Johnson | Internal Medicine | 9029 Hiwassee St Nw, Charleston, TN 37310-5305 | 2005-07-18 |
| 1255706388 | Amber Sharp | Physician Assistant | 9029 Hiwassee St Nw, Charleston, TN 37310-5305 | 2015-12-01 |
| 1912071259 | Kim D Dees | Family Medicine | 9029 Hiwassee St Nw, Charleston, TN 37310-5305 | 2006-11-20 |
| 1558476598 | Preferred Family Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8896 Hiwassee St Nw, Charleston, TN 37310-5340 | 2006-08-20 |
| 1215225206 | James Clifton Griffin | Pharmacist | 8897 Hiwassee St Nw, Charleston, TN 37310-5367 | 2011-07-12 |
| Find all providers in zip 37310 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447758032 | Crs Eyecare Services, Inc. | Clinic/Center | 112 Rutledge Ave Ste A, Charleston, SC 29401-1333 | 2018-01-29 |
| 1760829519 | Health First | Clinic/Center | 1115 Savannah Hwy, Charleston, SC 29407-7805 | 2013-06-03 |
| 1235108721 | Charleston Internal Medicine, LLC | Clinic/Center | 537 Folly Rd, Charleston, SC 29412-3007 | 2006-03-16 |
| 1174520068 | Jeffery L Deal | Clinic/Center | 1938 Charlie Hall Blvd Unit B, Charleston, SC 29414-6099 | 2005-07-07 |
| 1033778642 | Kanawha County Emergency Ambulance Authority Health and Wellness Board | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2019-06-07 |
| 1376033829 | Charleston Medical Associates | Clinic/Center | 1483 Tobias Gadson Blvd Ste 101, Charleston, SC 29407-4795 | 2018-05-10 |
| 1528560083 | Kanawha County Emergency Ambulance Authority | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2018-03-01 |
| 1639604929 | Lowcountry Wellness Center LLC | Clinic/Center | 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 | 2017-04-25 |
| 1770905952 | Charleston Primary Care Inc. | Clinic/Center | 506 W Lincoln Ave, Suite 200, Charleston, IL 61920-2453 | 2014-01-07 |
| 1336577238 | Western Arkansas Primary Care | Clinic/Center | 2617 E Main St, Charleston, AR 72933-9637 | 2013-10-31 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 37310 |
Please comment or provide details below to improve the information on PREFERRED FAMILY MEDICAL CARE LLC.
| 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.