Carey Family Practice and Pediatrics PLLC
Organization Active NPI Family Medicine Physician · Hartsville, TN
NPI 1033970405 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1033970405
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CAREY FAMILY PRACTICE AND PEDIATRICS PLLC
- Practice address
- 220 Broadway
Hartsville, TN 37074-1304 - Phone
- (615) 374-2101
- Fax
- (615) 374-9632
- NPI assigned
- Jan 22, 2024
- Organization subpart
- No
Authorized official
- Name
- James D Carey, NP
- Title
- Owner
- Phone
- (615) 374-2101
Practitioners 4
-
James D Carey, APN
-
Jack Willard Carey III, M.D.
-
Jack W Carey Jr., MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2306542 | Carey Family Practice & Pediatrics, PLLC | Certificate of waiver | Jun 19, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240509002740 | TN | Part B Supplier - Clinic/Group Practice | 1951742899 |
Receives reassigned benefits from 2 practitioners Practice locations: Hartsville, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
220 Broadway
Hartsville, TN 37074-1304
Mailing address
220 Broadway
Hartsville, TN 37074-1304
Phone (615) 374-2101
Other names
- Carey Family Practice
Other providers in Hartsville, TN
- Leah K Brown
- Amy Fowler Broyles
- Thomas Patrick Broyles
- Jackson Burch
- Andrew Jordan Byrd
- Jack W Carey Jr.
- Jack Willard Carey III
- James D Carey
- Charlie Alexander Clay III
- Veronica Clay
All providers in Hartsville, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.