Active NPI
Neurology Center PLLC
- Neurology Physician
- Clarksville, TN
National Provider Identifier
1063897668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 41086
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Electrodiagnostic Medicine Physician | 204R00000X | 41086 | TN | |
| Neurology Physician | 2084N0400X | 41086 | TN | Primary |
| Sleep Medicine (Psychiatry & Neurology) Physician | 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 DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Nashville, TN
- NPI 1588630842
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.