NPIMap

Rutherford County Primary Care

Organization Active NPI Federally Qualified Health Center (FQHC) · Murfreesboro, TN

NPI 1114973237 · NPPES record last updated Jan 4, 2023

Key facts

NPI
1114973237
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
RUTHERFORD COUNTY PRIMARY CARE
Practice address
1453 Hope Way
Murfreesboro, TN 37129-3140
Phone
(615) 893-9390
Fax
(615) 893-4162
NPI assigned
May 26, 2006
Organization subpart
No

Authorized official

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

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
    CMS ownership CORPORATE OFFICER · OPERATIONAL/MANAGERIAL CONTROL · W-2 MANAGING EMPLOYEE

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

Medicare participation

Medicare fee-for-service enrollment
Enrolled (5 enrollments) in TN

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
Corporation · Non-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
Corporation · Non-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
Corporation · Non-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
Corporation · Non-profit
Incorporated
May 1, 1992 in TN
Enrollment address
1701 N Main St
Ste C
Shelbyville, TN 37160-2301

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 Director
Vice 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 Director
Chair		 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 Employee
Ceo		 Jul 23, 1996
Corporate Officer Jul 23, 1996
W-2 Managing Employee
Ceo		 Jul 23, 1996 100%
Operational/Managerial Control
Ceo		 Jul 23, 1996 100%
Rob Bragdon
Individual 		Corporate Officer Jan 1, 2022
Corporate Director
Secretary/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 Officer
Cfo		 Mar 25, 1995
W-2 Managing Employee
Cfo		 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

Medicare enrollment records

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

National Provider Directory

Locations

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

1453 Hope Way
#340B599600
Murfreesboro, TN 37129

1453 Hope Way
#A
Murfreesboro, TN 37129
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes
Family Nurse Practitioner
Group: 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 identifiers

IdentifierTypeStateIssuer
3370199MedicaidTN
4448201MedicaidTN

Other names

  • Primary Care & Hope Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 4, 2023.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370199",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4448201",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care & Hope Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murfreesboro, TN

All providers in Murfreesboro, TN · Federally Qualified Health Center (FQHC) in Tennessee

Sources for this page

Verify at the official NPI Registry.