Community Quick Care of Lavergne, PC
Organization Active NPI Family Medicine Physician · La Vergne, TN
NPI 1194023366 · NPPES record last updated Jun 5, 2012
Key facts
- NPI
- 1194023366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 339630 (TN)
- Legal business name
- COMMUNITY QUICK CARE OF LAVERGNE, PC
- Practice address
- 5148A Murfreesboro Rd
La Vergne, TN 37086-2712 - Phone
- (615) 213-1203
- Fax
- (615) 527-0270
- NPI assigned
- Mar 11, 2011
- Organization subpart
- No
Authorized official
- Name
- Jerry P. Eledge
- Title
- Ceo
- Phone
- (615) 943-5072
Subparts reporting this organization as parent 2
Practitioners 33
-
Lisa M Cejka, NP
-
Jamie T Davis, N.P.
-
Wenona E Dotson, FNP-C
-
Megan Morton McKenzie, FNP-C
-
Kimberly R Prichard, APRN
-
Ellen Huffaker Beam, FNP
-
John Glen Carson, NP-C
-
Michele Cayton, NP
-
Charles D Flynn, FNP-C
-
Casey E Ingle, FNP
-
Aminda Kim, FNP-BC
-
Leslie Jo King, FNP
-
Taina Ovchinnikov, FNP-BC
-
Sharon L Santos, FNP
-
Miaschia Bryanna Scott, APRN
-
Deborah F Smith, FNP
-
Robin R. Swensen, ARNP
-
Leigh A. Walling, APN
-
Michael Ryan Woods, FNP
-
Monica Wright, NP
-
Joan Lanier, APRN
-
Rojin Abdullah, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2023515 | Community Quick Care | Certificate of waiver | Apr 25, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110520000260 | TN | Part B Supplier - Clinic/Group Practice | 2466638705 |
Receives reassigned benefits from 27 practitioners Practice locations: La Vergne, TN |
National Provider Directory
Locations
1412 Trotwood Ave
Ste 39
Columbia, TN 38401
Phone (931) 490-0832
2545 Murfreesboro Pike
Nashville, TN 37217
Phone (615) 641-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 339630 | TN | Yes |
| Urgent Care Clinic/Center | 261QU0200X | 339630 | TN |
Addresses
Primary practice location
5148A Murfreesboro Rd
La Vergne, TN 37086-2712
Mailing address
PO Box 2684
Brentwood, TN 37024-2684
Phone (615) 943-5072
Other providers in La Vergne, TN
- Joseph Carter
- Lisa M Cejka
- Center for Excellence
- Ashley Chance
- Daniel Chera
- Compass Sky LLC
- Michelle Conteh
- Sara Cottrell
- Courageous People Therapy Center, LLC
- Mary T Crozier
All providers in La Vergne, 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 5, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.