EAST FORK MEDICAL CLINIC, LLC (NPI# 1710351820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710351820 |
| Entity Type | Organization |
| Organization Name | EAST FORK MEDICAL CLINIC, LLC |
| Practice Address |
370 Doolittle Rd #4 Woodbury TN 37190-1129 |
| Mailing Address |
322 Savannah Rdg Murfreesboro TN 37127-8349 |
| Practice Telephone | 6158557488 |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2015-11-30 |
| Authorized Official Name | MR. JACK DEMPSEY HYDRICK II (MANAGING MEMBER) |
| Authorized Official Telephone | 6158557488 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
370 DOOLITTLE RD #4 |
| City | WOODBURY |
| State | TN |
| Zip Code | 37190-1129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376544767 | James Riley Spurlock IIi | Family Medicine | 370 Doolittle Rd, Suite 1, Woodbury, TN 37190-1129 | 2005-08-09 |
| 1457640674 | James R Spurlock IIi Do | Nurse Practitioner | 370 Doolittle Rd, Suite 1, Woodbury, TN 37190-1129 | 2011-03-29 |
| 1407097736 | Lebanon Eye Associates | Ophthalmology | 370 Doolittle Rd, Suite 4, Woodbury, TN 37190-1129 | 2009-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376143891 | Results-ast Jv, LLC | Physical Therapist | 324 Doolittle Road, Woodbury, TN 37190 | 2020-10-26 |
| 1255407219 | Catherine Lorraine Levi | Physical Therapy Assistant | 119 West High Street, Woodbury, TN 37190 | 2006-11-28 |
| 1669807830 | Heather J Melton | Nurse Practitioner | 89 Mears Drive, Woodbury, TN 37190 | 2013-09-06 |
| 1639245681 | James L Mayes | Physical Therapist | 324 Doolittle Rd, Woodbury, TN 37190 | 2006-11-28 |
| 1811063878 | Melisa Johnson Curtis | Physical Therapy Assistant | 324 Doolittle Rd, Stones River Hospital Inpatient Rehab, Woodbury, TN 37190 | 2006-11-28 |
| 1437677796 | Woodbury Drug Center LLC | Pharmacy | 604 W Main St, Woodbury, TN 37190-1029 | 2017-09-06 |
| 1437148905 | Darryl T Deason | Dentist | 801b W Main St, Woodbury, TN 37190-1032 | 2005-10-18 |
| 1629067855 | Andrew P Bucher | Dentist | 801b W Main St, Woodbury, TN 37190-1032 | 2005-10-20 |
| 1003360793 | Woodbury Dental Partners | Dentist | 801 W Main St, Suite B, Woodbury, TN 37190-1047 | 2016-08-10 |
| 1407000417 | Darryl T Deason | Dentist | 801 W Main St, Suite B, Woodbury, TN 37190-1047 | 2008-11-05 |
| Find all providers in zip 37190 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477915163 | Richard D. Abrash Md PC | Clinic/Center | 800 Woodbury Rd, Suite I, Woodbury, NY 11797-2503 | 2016-03-22 |
| 1497036198 | Balsam Medical, Pllc | Clinic/Center | 530 W Adams St, Woodbury, TN 37190-1622 | 2011-09-08 |
| 1396721387 | Central Pediatrics, P.a. | Clinic/Center | 9680 Tamarack Rd Ste 100, Woodbury, MN 55125-2623 | 2005-12-21 |
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|---|---|---|---|---|
| 1780281527 | Braxton Medical Clinic, LLC | Clinic/Center | 1410 Kensington Square Ct Ste 103, Murfreesboro, TN 37130-6902 | 2020-10-05 |
| 1629689674 | Saint Thomas Medical Partners | Clinic/Center | 220 West Jefferson Pike, Murfreesboro, TN 37129 | 2020-08-13 |
| 1700411592 | Fentress Family Care LLC | Clinic/Center | 1010 Old Highway 127 S, Jamestown, TN 38556-5648 | 2020-03-11 |
| 1831724822 | Guiding Star Memphis | Clinic/Center | 2980 Poplar Ave Ste 101, Memphis, TN 38111-3527 | 2020-03-10 |
| 1407486764 | Elijahs Dream Compassionate Care | Clinic/Center | 134 Creekside Dr Ste 1, Ocoee, TN 37361-3653 | 2020-01-24 |
| 1518506542 | Faith Medical Group, Pllc | Clinic/Center | 500 Mcfarland St Ste E, Morristown, TN 37814-3992 | 2019-12-20 |
| 1366080582 | Matthew E. Schantz, M.d. | Clinic/Center | 206 S Military St Ste 1, Loretto, TN 38469-2101 | 2019-12-18 |
| 1114563749 | Step One Medical Associates PC | Clinic/Center | 4502 Bristol Hwy, Johnson City, TN 37601-2936 | 2019-11-19 |
| 1023665403 | Elite Healthcare, LLC | Clinic/Center | 117 N 3rd St, Kingston, TN 37763-2842 | 2019-08-21 |
| 1083266381 | Get Into Shape Md | Clinic/Center | 5803 Lee Hwy Ste 101, Chattanooga, TN 37421-3547 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
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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.