Organization Active NPI

TLC Family Health & Hormone PLLC

  • Family Nurse Practitioner
  • Tullahoma, TN
National Provider Identifier
1164993689
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TLC FAMILY HEALTH & HORMONE PLLC
Practice address
215 S Anderson St
Tullahoma, TN 37388-3735
Phone
(931) 563-7464
Fax
(931) 563-7401
NPI assigned
Dec 10, 2018
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Dana Jackson, NPNPI 1306330840
Title
Owner
Phone
(931) 563-7464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

215 S Anderson St
Tullahoma, TN 37388-3735

Mailing address

PO Box 326
Winchester, TN 37398-0326
Phone (931) 563-7464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190226001003 TN Part B Supplier - Clinic/Group Practice 8729327317 Receives reassigned benefits from 3 practitioners
Practice locations: Tullahoma, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2165773TLC Family Health & Hormone, PLLC215 S Anderson Street, Tullahoma, TN 37388Provider-performed microscopyDec 31, 2026

National Provider Directory

National Provider Directory

Locations

215 S Anderson St
Tullahoma, TN 37388
Phone (931) 563-7464

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1164993689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373980326",
            "telephone_number": "931-563-7464",
            "fax_number": "931-563-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S ANDERSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883735",
            "telephone_number": "931-563-7464",
            "fax_number": "931-563-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC FAMILY HEALTH & HORMONE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-563-7464",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.