HUMBOLDT FAMILY WALK-IN CLINIC LLC


Address: 1600 Coleman Dr, Humboldt, TN 38343-1756
Phone: 7314704020

HUMBOLDT FAMILY WALK-IN CLINIC LLC (NPI# 1881135895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881135895
Entity Type Organization
Organization Name HUMBOLDT FAMILY WALK-IN CLINIC LLC
Practice Address 1600 Coleman Dr
Humboldt
TN 38343-1756
Mailing Address 1600 Coleman Dr
Humboldt
TN 38343-0068
Practice Telephone 7314704020
Practice Fax Number 7315620349
Mailing Telephone 7314704020
Mailing Fax Number 7315620349
Enumeration Date 2017-03-10
Last Update Date 2019-12-09
Authorized Official Name DEBORAH L GRAVES (OWNER)
Authorized Official Telephone 7314704020
Authorized Official Credential MSN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
Ambulatory Health Care Facilities

Office Location

Street Address 1600 COLEMAN DR
City HUMBOLDT
State TN
Zip Code 38343-1756

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NPI Name Taxonomy Address Enumeration
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1346521911 Barbara Jean Potts Registered Nurse 149 12th Street, Humboldt, TN 38343 2011-09-08
1871881920 Joyce Ama Addo Physician Assistant 1804 Main Street, Rainbow Pediatric, Humboldt, TN 38343 2011-07-11
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

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1700180403 The Family Physicians Pa Clinic/Center 111 S 9th, Humboldt, KS 66748-1809 2011-01-10
1649724923 Iowa Physicians Clinic Medical Foundation Clinic/Center 1010 15th St N, Humboldt, IA 50548-1008 2016-08-04
1619246899 Trimark Physicians Group Clinic/Center 1010 15th St N, Humboldt, IA 50548-1008 2011-12-18
1184793499 Ashley Clinic LLC Clinic/Center 202 S 9th St, Humboldt, KS 66748-1908 2006-11-08
1992781082 Trimark Physicians Group Inc Clinic/Center 1010 15th St N, Humboldt, IA 50548-1008 2005-12-20

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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
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1871034462 Martin Health Clinic/Center 143 Kennedy Drive, Martin, TN 38237-3309 2017-03-15
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Competitor

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City HUMBOLDT
Zip Code 38343

Improve Information

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Dataset Information

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.

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