MAIN STREET FAMILY CARE PLLC (NPI# 1770012676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770012676 |
| Entity Type | Organization |
| Organization Name | MAIN STREET FAMILY CARE PLLC |
| Practice Address |
211 Church St Tiptonville TN 38079-1109 |
| Practice Telephone | 7315710569 |
| Mailing Telephone | 7315710569 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2019-10-31 |
| Authorized Official Name | MISTY C BARKER (NP/OWNER) |
| Authorized Official Telephone | 7315710569 |
| Authorized Official Credential | NP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Street Address |
211 CHURCH ST |
| City | TIPTONVILLE |
| State | TN |
| Zip Code | 38079-1109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689914632 | Kerri A Ervin | Nurse Practitioner | 211 Church St, Tiptonville, TN 38079-1109 | 2013-02-27 |
| 1366614588 | Blue Ribbon Dental Center LLC | Health Maintenance Organization | 211 Church St, Tiptonville, TN 38079-1109 | 2008-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356893044 | John Mancell | Pharmacist | 650 Carl Perkins Pkwy, Tiptonville, TN 38079 | 2016-10-27 |
| 1982048757 | Astin Berry | Physical Therapy Assistant | 3195 Cates Landing Rd N, Tiptonville, TN 38079 | 2013-04-24 |
| 1821383670 | Roberson Rike Clinic | Nurse Practitioner | 768 Everett St., Tiptonville, TN 38079 | 2011-06-09 |
| 1366648735 | Amanda Collins | Physician Assistant | Northwest Corrections, Tiptonville, TN 38079 | 2007-06-22 |
| 1710011994 | Sandra Lynnette Smith | Registered Nurse | 400 Hwy 78 S, Tiptonville, TN 38079 | 2007-03-16 |
| 1871643031 | State of Tennessee | Public Health or Welfare | 400 Hwy 78 South, Tiptonville, TN 38079 | 2007-01-11 |
| 1508807736 | Daniel W. Bruce | Legal Medicine | 708 Everett St, Tiptonville, TN 38079 | 2006-06-09 |
| 1841311529 | Citizens of Lake County for Health Care Inc | Clinic/Center | 710 Carl Perkins Pkwy, Tiptonville, TN 38079 | 2007-04-02 |
| 1891137832 | Love In Action Caregivers Inc. | Home Health | 212 Church St, Tiptonville, TN 38079-1110 | 2013-07-18 |
| 1730179250 | County of Lake | Ambulance | 333 Kentucky St, Tiptonville, TN 38079-1212 | 2005-10-26 |
| Find all providers in zip 38079 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1447861562 | Henry County Medical Center | Clinic/Center | 14201 Highway 79 N Unit 4, Buchanan, TN 38222-4183 | 2020-08-12 |
| 1003425224 | Dickson Medical Associate, PC | Clinic/Center | 127 Crestview Park Dr Ste 205, Dickson, TN 37055-2856 | 2020-07-23 |
| 1023631454 | Spring City Family Clinic Pllc | Clinic/Center | 126 Lavender St Ste 2, Spring City, TN 37381-5102 | 2020-05-20 |
| 1871001271 | Shelbyville Hospital Company LLC | Clinic/Center | 1330 Cedar Ln Ste 100, Tullahoma, TN 37388-2284 | 2018-01-19 |
| 1720596125 | Shelbyville Hospital Company LLC | Clinic/Center | 1440 Cedar Ln Unit 100, Tullahoma, TN 37388-2262 | 2018-01-19 |
| 1548788458 | Shelbyville Hospital Company LLC | Clinic/Center | 1612 N Main St Ste A, Shelbyville, TN 37160-2392 | 2017-08-31 |
| 1063938520 | Mid-south Convenient Care, Pllc | Clinic/Center | 1445 Us Highway 51 Byp E Ste B, Dyersburg, TN 38024-2127 | 2017-08-16 |
| 1871034462 | Martin Health | Clinic/Center | 143 Kennedy Drive, Martin, TN 38237-3309 | 2017-03-15 |
| 1881135895 | Humboldt Family Walk-in Clinic LLC | Clinic/Center | 1600 Coleman Dr, Humboldt, TN 38343-1756 | 2017-03-10 |
| Find all providers with the same taxonomy | ||||
| City | TIPTONVILLE |
| Zip Code | 38079 |
Please comment or provide details below to improve the information on MAIN STREET FAMILY CARE PLLC.
| 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.