NPIMap

Organization Active NPI

Lincoln Medical Center OBGYN Clinic

  • Obstetrics & Gynecology Physician
  • Fayetteville, TN
National Provider Identifier
1053604298
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LINCOLN MEDICAL CENTER OBGYN CLINIC
Practice address
108 Medical Center Blvd
Suite 150
Fayetteville, TN 37334-2741
Phone
(931) 433-1105
Fax
(931) 433-1171
NPI assigned
May 20, 2011
Last updated
May 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Authorized official

Name
Robin Marshall
Title
Office Manager
Phone
(931) 433-1105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

108 Medical Center Blvd
Suite 150
Fayetteville, TN 37334-2741

Mailing address

108 Medical Center Blvd
Suite 150
Fayetteville, TN 37334-2741
Phone (931) 433-1105

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1053604298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD",
            "address_2": "SUITE 150",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342741",
            "telephone_number": "931-433-1105",
            "fax_number": "931-433-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD",
            "address_2": "SUITE 150",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342741",
            "telephone_number": "931-433-1105",
            "fax_number": "931-433-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN MEDICAL CENTER OBGYN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-20",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-433-1105"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.