NPIMap

Organization Active NPI

Complete Express Care, LLC

  • Urgent Care Clinic/Center
  • Winchester, TN
National Provider Identifier
1083909204
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
COMPLETE EXPRESS CARE, LLC
Practice address
1211 Dinah Shore Blvd
Winchester, TN 37398-1107
Phone
(931) 967-6669
Fax
(931) 967-6606
NPI assigned
Jun 15, 2011
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Mr. Floyd Don Davis
Title
Owner
Phone
(931) 967-6669

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X TN Primary
Medical Physician Assistant 363AM0700X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

1211 Dinah Shore Blvd
Winchester, TN 37398-1107

Mailing address

1211 Dinah Shore Blvd
Winchester, TN 37398-1107
Phone (931) 967-6669

Other identifiers 1

IdentifierTypeStateIssuer
1527276MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110812000392 TN Part B Supplier - Clinic/Group Practice 5294904017 Receives reassigned benefits from 8 practitioners
Practice locations: Winchester, TN

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
44D2028087Complete Express Care1211 Dinah Shore Blvd, Winchester, TN 37398Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Locations

1856 Decherd Blvd
Decherd, TN 37324
Phone (931) 962-4082

1211 Dinah Shore Blvd
Winchester, TN 37398
Phone (931) 967-6669

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1083909204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 DINAH SHORE BLVD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981107",
            "telephone_number": "931-967-6669",
            "fax_number": "931-967-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 DINAH SHORE BLVD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373981107",
            "telephone_number": "931-967-6669",
            "fax_number": "931-967-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE EXPRESS CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-967-6669",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527276",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.