Active NPI
Neighborhood Clinic, PLLC
- Family Nurse Practitioner
- Paris, TN
National Provider Identifier
1104366988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APN7205
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q026850 | Medicaid | TN |
National Provider Directory
National Provider DirectoryLocations
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.