Covenant Medical Fairview, PC
Organization Active NPI Family Medicine Physician · Fairview, TN
NPI 1164099339 · NPPES record last updated Jun 7, 2021
Key facts
- NPI
- 1164099339
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- COVENANT MEDICAL FAIRVIEW, PC
- Practice address
- 2340 Fairview Blvd Ste 600D
Fairview, TN 37062-9457 - Phone
- (615) 266-2177
- NPI assigned
- Jun 7, 2021
- Organization subpart
- No
Authorized official
- Name
- Kelley R Carpenter
- Title
- Practice Administrator
- Phone
- (615) 218-8566
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2100921 | Covenant Medical- Fairview | Certificate of waiver | Aug 24, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
2340 Fairview Blvd Ste 600D
Fairview, TN 37062-9457
Mailing address
2340 Fairview Blvd Ste 600D
Fairview, TN 37062-9457
Phone (615) 266-2177
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://covenantmed.com/ |
Other providers in Fairview, TN
- Erin Castellaw
- Centerstone
- Amanda Clark
- Teresa Marie Clark
- Joseph Cottone
- Kelly Lea Cox
- Austin Daugherty
- Janet Mary Devasia
- Caroline Shultz Devault
- Dickson Medical Associates, PC
All providers in Fairview, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.