Organization Active NPI

Neurology Center PLLC

  • Neurology Physician
  • Clarksville, TN
National Provider Identifier
1063897668
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
41086 Issued in TN
Legal business name
NEUROLOGY CENTER PLLC
Practice address
1750 Memorial Dr
Suite C
Clarksville, TN 37043-6356
Phone
(931) 905-4144
Fax
(931) 905-4143
NPI assigned
Jul 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Dr. Jacqueline Rose Ansell, MD
Title
Sole Proprietor
Phone
(931) 905-4144

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204R00000X 41086 TN
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 41086 TN Primary
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084S0012X 41086 TN

Addresses

Primary practice location

1750 Memorial Dr
Suite C
Clarksville, TN 37043-6356

Mailing address

2000 Queens Bluff Way
Clarksville, TN 37043-4858
Phone (931) 905-4144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1063897668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 QUEENS BLUFF WAY",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434858",
            "telephone_number": "931-905-4144",
            "fax_number": "931-905-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 MEMORIAL DR",
            "address_2": "SUITE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436356",
            "telephone_number": "931-905-4144",
            "fax_number": "931-905-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "ANSELL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "931-905-4144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": "TN",
            "license": "41086",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "41086",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TN",
            "license": "41086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.