Montclair Health and Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000006822 Issued in TN

Legal business name

MONTCLAIR HEALTH AND WELLNESS LLC

Practice address

710 Cornersville Rd
Lewisburg, TN 37091

Phone

(931) 994-5717

Fax

(931) 246-4233

NPI assigned

Mar 24, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela D White

Title

Office Manager

Phone

(931) 212-1117

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Specialty Associates Doing business as

Locations

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1013216498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CORNERSVILLE RD",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "37091",
            "telephone_number": "931-422-2192",
            "fax_number": "931-246-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CORNERSVILLE RD",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "37091",
            "telephone_number": "931-994-5717",
            "fax_number": "931-246-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-212-1117",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000012854",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000006822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005482",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Specialty Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Miller, OTR/L
• Nathan E Miller, PT
• Suzanne Miller, NURSE PRACTIONER
• Veronica Mojica
• Dominic Montalto, OT
• Jamese Moore
• Emily Nicole Morris, CNA
• Alexandria Nicole Morrison, COTA/L
• Hunter Douglas Morrow, DMD
• Leslie Morrow, RN

• Family Nurse Practitioner in Lewisburg, TN
• Providers in Lewisburg, 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 Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.