NPIMap

Organization Active NPI

MH Health Care Services, PC

  • Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1013506567
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MH HEALTH CARE SERVICES, PC
Practice address
1055 Vendall Rd
Dyersburg, TN 38024-1622
Phone
(802) 857-0400
NPI assigned
Jan 11, 2021
Organization subpart
Yes
Parent organization
MH HEALTH CARE SERVICES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Nancy Carlson, MD
Title
President
Phone
(802) 857-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1055 Vendall Rd
Dyersburg, TN 38024-1622

Mailing address

20 Winooski Falls Way Ste 400
Winooski, VT 05404-2239

Other names 1

  • MH HCS at Tyson Newbern Other name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2214995Bright Blue at MH Health Care Services, PC1055 Vendall Road, Dyersburg, TN 38024Certificate of waiverFeb 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
MH Health Care Services PC151 organizations share this tax ID, including this one
Part of
MH Health Care Services PC

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1055 Vendall Rd
Dyersburg, TN 38024
Phone (731) 882-7224

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1013506567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WINOOSKI FALLS WAY STE 400",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054042239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 VENDALL RD",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241622",
            "telephone_number": "802-857-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MH HEALTH CARE SERVICES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MH HEALTH CARE SERVICES, PC",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-857-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MH HCS at Tyson Newbern",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.