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NPI Code Detail

MEDICARE: RUTHERFORD COUNTY PRIMARY CARE

MEDICARE: RUTHERFORD COUNTY PRIMARY CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114973237
Entity Type Code : Organization
Provider Name (Legal Business Name) : RUTHERFORD COUNTY PRIMARY CARE
Provider Business Mailing Address
First Line : 1453 HOPE WAY
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-3140
Country : US
Telephone Number : 615-893-9390
Fax Number : 615-893-4162
Provider Business Practice Location Address
First Line : 1453 HOPE WAY
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-3140
Country : US
Telephone Number : 615-893-9390
Fax Number : 615-893-4162
Authorized Official
Title or Position : FINANCIAL OFFICER
Name : MS. SHANE SMITH
Credential :
Telephone Number : 615-893-9390
Provider Enumeration Date : 05/26/2006
Last Update Date : 01/04/2023

Similar Medicare Providers

1669331310 — PAMELA GENTRY LCSW
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax:
1467138511 — SARAH EILEEN MCCLENNEY FNP
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax:
1346000502 — JORDANNA BROOKE TWILLEY PMHNP
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax:
1578510970 — MS. LISA ANN TERRY NP
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax: 615-893-4162
1699838508 — MRS. MYRA JOHNSON MILLER LCSW
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax:
1770639619 — DR. DAVID LEE JOHNSON M.D.
Practice Location Address:
1453 HOPE WAY
MURFREESBORO, TN
37129-3140
Practice Phone: 615-893-9390
Practice Fax: 615-893-4162

Directions to “RUTHERFORD COUNTY PRIMARY CARE ” Practice Location

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