NPIMap

Organization Active NPI

Dyersburg Clinic Corp

  • Family Medicine Physician
  • Dyersburg, TN
National Provider Identifier
1093710568
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DYERSBURG CLINIC CORP
Practice address
400 E Tickle St
Dyersburg, TN 38024-3120
Phone
(731) 288-7250
Fax
(731) 288-7258
NPI assigned
Jun 20, 2005
Last updated
Aug 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Debbie T Brewer
Title
Director
Phone
(615) 465-7626

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X TN Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X

Addresses

Primary practice location

400 E Tickle St
Dyersburg, TN 38024-3120

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37027-2829
Phone (615) 465-7000

National Provider Directory

National Provider Directory

Locations

503 E Tickle St
Ste A
Dyersburg, TN 38024
Phone (731) 285-5244

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1093710568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7000",
            "fax_number": "615-309-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E TICKLE ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243120",
            "telephone_number": "731-288-7250",
            "fax_number": "731-288-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYERSBURG CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-465-7626"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.