Individual provider Active NPI

Mary Eve Rice, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1154531127
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
12411 Issued in TN
Practice address
490 Dunlop LN
Clarksville, TN 37040-5007
Phone
(931) 245-7000
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 12411 TN Primary

Addresses

Primary practice location

490 Dunlop LN
Clarksville, TN 37040-5007

Mailing address

812 Brooke Valley Trce
Clarksville, TN 37043-5933
Phone (931) 552-6535

Other identifiers 1

IdentifierTypeStateIssuer
Q026412MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mary.rice.2@7977.direct.athenahealth.com Direct Premier Medical Group PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316002001 TN Practitioner - Nurse Practitioner 1951587088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12411TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group PC CurrentSince Feb 18, 2021 Accepting new patients
Pound Family Chiropractic Inc Past Accepting new patients

Locations

2831 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (931) 245-8600

Interoperability endpoints

  • Direct secure messaging: mary.rice.2@7977.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1154531127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 BROOKE VALLEY TRCE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435933",
            "telephone_number": "931-552-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 DUNLOP LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405007",
            "telephone_number": "931-245-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "MARY",
        "middle_name": "EVE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "12411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026412",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.rice.2@7977.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Premier Medical Group PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "490 Dunlop Ln",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.