NPIMap

Organization Active NPI

Rutherford County Primary Care

Doing business as Primary Care & Hope Clinic

  • Federally Qualified Health Center (FQHC)
  • Murfreesboro, TN
National Provider Identifier
1114973237
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RUTHERFORD COUNTY PRIMARY CARE
Doing business as
Primary Care & Hope Clinic
Practice address
1453 Hope Way
Murfreesboro, TN 37129-3140
Phone
(615) 893-9390
Fax
(615) 893-4162
NPI assigned
May 26, 2006
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Ms. Shane Smith
Title
Financial Officer
Phone
(615) 893-9390

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1453 Hope Way
Murfreesboro, TN 37129-3140

Mailing address

1453 Hope Way
Murfreesboro, TN 37129-3140
Phone (615) 893-9390

Other names 1

  • Primary Care & Hope Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20040817000631 TN Part B Supplier - Clinic/Group Practice 6305819483 Receives reassigned benefits from 44 practitioners
Practice locations: Murfreesboro, TN
O20100922000431 TN Part A Provider - Federally Qualified Health Center (FQHC) 6305819483 Practice locations: Murfreesboro, TN
O20101104000571 TN Part A Provider - Federally Qualified Health Center (FQHC) 6305819483 Practice locations: Murfreesboro, TN
O20120703000344 TN Part A Provider - Federally Qualified Health Center (FQHC) 6305819483 Practice locations: Smyrna, TN
O20180430000799 TN Part A Provider - Federally Qualified Health Center (FQHC) 6305819483 Practice locations: Shelbyville, TN

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1114973237. Details of each certification follow.

Federally qualified health center certification: CCN 441934

Legal name
RUTHERFORD COUNTY PRIMARY CARE
Doing business as
PRIMARY CARE & HOPE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2010
Last certification
Sep 22, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1992 in TN
Enrollment address
1453 Hope Way
Murfreesboro, TN 37129-3140

Federally qualified health center certification: CCN 441939

Legal name
RUTHERFORD COUNTY PRIMARY CARE
Doing business as
PRIMARY CARE & HOPE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 5, 2010
Last certification
Nov 5, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1992 in TN
Enrollment address
1313 Memorial Blvd
Murfreesboro, TN 37129-2422

Federally qualified health center certification: CCN 441949

Legal name
RUTHERFORD COUNTY PRIMARY CARE
Doing business as
PRIMARY CARE & HOPE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 6, 2012
Last certification
Jul 6, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1992 in TN
Enrollment address
900 SGT Asbury Hawn Way
Smyrna, TN 37167-3587

Federally qualified health center certification: CCN 441988

Legal name
RUTHERFORD COUNTY PRIMARY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 30, 2018
Last certification
Apr 30, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1992 in TN
Enrollment address
1701 N Main St
Ste C
Shelbyville, TN 37160-2301

National Provider Directory

National Provider Directory

Locations

1453 Hope Way
Murfreesboro, TN 37129
Phone (615) 893-9390

1453 Hope Way
#340B599600
Murfreesboro, TN 37129

1453 Hope Way
#A
Murfreesboro, TN 37129
Phone (615) 893-9390

608 S Hancock St
Murfreesboro, TN 37130
Phone (615) 893-9390

900 Sgt Asbury Hawn Way
Smyrna, TN 37167
Phone (615) 625-9390

900 Sgt Asbury Hawn Way
#340B599600
Smyrna, TN 37167

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Brenda Whitlock Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2018
Leslie N Akins Individual Corporate Officer Jan 1, 2022
Corporate DirectorVice Chair Jan 1, 1997
Laura Davis Individual Corporate Officer Jan 1, 2021
Corporate Director Jan 1, 2018
Wendy Thomason Individual W-2 Managing Employee Nov 28, 2016
Kelly Climer Individual Corporate Officer Jan 1, 2021
Corporate Director Jan 1, 2018
Phillip Jackson Individual Corporate Officer Jan 1, 2022
Corporate Officer Jan 1, 2004
Corporate DirectorChair Jan 1, 2018
Sheena King Individual Corporate Officer Jan 1, 2022
Corporate Officer Jan 1, 2013
Mary Reed Individual Corporate Officer Jan 1, 2021
Corporate Director Oct 26, 2017
Lisa a Terry Individual W-2 Managing Employee Jul 23, 1996
W-2 Managing EmployeeCeo Jul 23, 1996
Corporate Officer Jul 23, 1996
W-2 Managing EmployeeCeo Jul 23, 1996 100%
Operational/Managerial ControlCeo Jul 23, 1996 100%
Rob Bragdon Individual Corporate Officer Jan 1, 2022
Corporate DirectorSecretary/Treasurer Jan 1, 2006
Rutherford County Primary Care Organization, Murfreesboro, TN Operational/Managerial Control Jul 20, 2010
Operational/Managerial Control Sep 1, 2010
Operational/Managerial Control May 21, 2012
Kristy Davis Individual W-2 Managing Employee Jan 1, 2016
W-2 Managing Employee Oct 13, 2009
Shawn McFarland Individual Corporate Officer Jan 1, 2022
Corporate Director Mar 17, 2017
Shane Smith Individual W-2 Managing Employee Mar 25, 1995
Corporate OfficerCfo Mar 25, 1995
W-2 Managing EmployeeCfo Mar 25, 1995
Corporate Officer Mar 20, 1995
Operational/Managerial Control Mar 25, 1995
Jo Edwards Individual Corporate Officer Jan 1, 2021
Corporate Director May 1, 1992
Terry Haynes Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Lisa Ann Terry, NP
    • Family Nurse Practitioner
    • Murfreesboro, TN
    • NPI 1578510970

    Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1114973237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 HOPE WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293140",
            "telephone_number": "615-893-9390",
            "fax_number": "615-893-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 HOPE WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293140",
            "telephone_number": "615-893-9390",
            "fax_number": "615-893-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTHERFORD COUNTY PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "615-893-9390",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care & Hope Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.