Organization Active NPI

Neighborhood Clinic, PLLC

  • Family Nurse Practitioner
  • Paris, TN
National Provider Identifier
1104366988
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN7205 Issued in TN
Legal business name
NEIGHBORHOOD CLINIC, PLLC
Practice address
201 N Brewer St
Paris, TN 38242-4027
Phone
(731) 415-3574
Fax
(731) 240-0232
NPI assigned
Feb 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Steve Prosser
Title
Practice Manager
Phone
(731) 499-2319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APN7205 TN Primary

Addresses

Primary practice location

201 N Brewer St
Paris, TN 38242-4027

Mailing address

1190 Pettijohn Creek Rd
Henry, TN 38231-4123
Phone (731) 499-2319

Other practice location 1

1190 Pettijohn Creek Rd
Henry, TN 38231-4123
Phone (731) 499-2319

Other practice location 2

801 E Wood St
Paris, TN 38242-4223
Phone (731) 415-3574

Other identifiers 1

IdentifierTypeStateIssuer
Q026850MedicaidTN

National Provider Directory

National Provider Directory

Locations

801 E Wood St
Paris, TN 38242
Phone (731) 415-3574

201 N Brewer St
Paris, TN 38242
Phone (731) 415-3574

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1104366988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 PETTIJOHN CREEK RD",
            "city": "HENRY",
            "state": "TN",
            "postal_code": "382314123",
            "telephone_number": "731-499-2319",
            "fax_number": "866-670-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BREWER ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424027",
            "telephone_number": "731-415-3574",
            "fax_number": "731-240-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 Pettijohn Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Henry",
            "state": "TN",
            "postal_code": "382314123",
            "country_code": "US",
            "telephone_number": "731-499-2319",
            "fax_number": "731-499-8175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 E Wood St",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TN",
            "postal_code": "382424223",
            "country_code": "US",
            "telephone_number": "731-415-3574",
            "fax_number": "866-670-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEIGHBORHOOD CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "PROSSER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "731-499-2319",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN7205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026850",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.