Faith Family Medical Clinic, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FAITH FAMILY MEDICAL CLINIC, LLC

Practice address

511 E Main St
Brownsville, TN 38012

Phone

(731) 734-2023

Fax

(877) 753-3133

NPI assigned

Jul 3, 2018

Last updated

Sep 22, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Franklin Callery, MSN, FNP-CNPI 1780073213

Title

Owner

Phone

(731) 734-2023

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Franklin Callery, MSN, FNP-C

  • Family Nurse Practitioner
  • Brownsville, TN
  • NPI 1780073213
  Medicare reassignment Care Compare group NPD Authorized official
• Madalyn Guymon, FNP-C

  • Family Nurse Practitioner
  • Brownsville, TN
  • NPI 1275398794
  Medicare reassignment Care Compare group NPD
• William Arthur Willis, M.D.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1518946946
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1003302951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E MAIN ST",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380124113",
            "telephone_number": "731-734-2023",
            "fax_number": "877-753-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E MAIN ST",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "38012",
            "telephone_number": "731-734-2023",
            "fax_number": "877-753-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH FAMILY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "CALLERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-734-2023",
        "authorized_official_credential": "MSN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037097",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dupree SNF Healthcare LLC (Haywood Post Acute)
• Dyersburg Clinic Corp (Haywood Park Urgent Care)
• Arthur H Ellis III, OD
• Adam P English, D.O.
• Susan B Esquivias
• Fast Pace Medical Clinic PLLC
• Katherine Finan, M.S., R.D., L.D.N.
• Firstcare Medical Center, PC
• Heidi Ann Flowers, MSN, APRN, FNP-C
• Edric Gaylor, PT, DPT

• Family Nurse Practitioner in Brownsville, TN
• Providers in Brownsville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.