Mark A Vann, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Decherd, TN
NPI 1194036327 · NPPES record last updated Feb 26, 2013
Key facts
- NPI
- 1194036327
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 15060 (TN)
- Practice address
- 2008 Decherd Blvd
Decherd, TN 37324-3818 - Phone
- (931) 962-9000
- Fax
- (931) 967-1791
- NPI assigned
- Jun 22, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Woodland Wellness Inc
Practice addresses (Care Compare)
115 N Woodland St
Manchester, TN 37355-1573
Phone (931) 954-5219
Hospital & facility affiliations
- Adoration Home Health, LLC
- Suncrest Home Health
- Amedisys Home Care
- Unity Medical Center
- Vanderbilt Tullahoma-Harton Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Woodland Wellness Inc |
Rural health clinic | 5% Or Greater Direct Ownership Interest Corporate Officer W-2 Managing Employee Operational/Managerial Control |
Mar 23, 2018 Mar 23, 2018 Mar 23, 2018 Mar 23, 2018 |
| Woodland Wellness of Tullahoma |
Rural health clinic | 5% Or Greater Direct Ownership Interest (50%) Corporate Officer (50%) W-2 Managing Employee (50%) |
Mar 23, 2018 Mar 23, 2018 Mar 23, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101103000886 | TN | Practitioner - Nurse Practitioner | 4880798297 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coffee Medical Group LLC | Current |
Accepting new patients | |
| Woodland Wellness, Inc | Current |
Accepting new patients | |
| Coffee Medical Group LLC | Current |
Accepting new patients | |
| Henson'S Family Medical LLC | Family | Current | Accepting new patients |
| Woodland Wellness, Inc | Current |
Accepting new patients | |
| Accurate Medical Practice Solutions | Past |
Accepting new patients | |
| Coffee Medical Group LLC | Past | Accepting new patients |
Locations
481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586
482 Interstate Dr
Manchester, TN 37355
Phone (931) 728-4718
115 N Woodland St
Manchester, TN 37355
Phone (931) 723-7904
501 N Jackson St
Tullahoma, TN 37388
Phone (931) 222-4213
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15060 | TN | Yes |
Addresses
Primary practice location
2008 Decherd Blvd
Decherd, TN 37324-3818
Mailing address
2008 Decherd Blvd.
Decherd, TN 37324
Phone (931) 962-9000
Other providers in Decherd, TN
- Kerri Takata
- Tennessee CVS Pharmacy, L.L.C.
- Tennessee Pain Management and Rehabilitation PC
- Brandi Leanne Thoma
- Andrea Barnett Turner
- Walgreen Co
- Lexi Watson
- Brittney Whitmore
- Tiffany Nicole Wiley-Cox
- Linda Rose Williams
All providers in Decherd, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2013. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- 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.