Whiteville Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WHITEVILLE MEDICAL CENTER LLC

Practice address

2400 US Highway 64
Whiteville, TN 38075-7461

Phone

(731) 254-8999

Fax

(731) 254-8997

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Mary Lockhart

Title

Manager

Phone

(901) 483-5370

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rylie Gordon, FNP

  • Family Nurse Practitioner
  • Whiteville, TN
  • NPI 1841004298
  Medicare reassignment Care Compare group NPD
• Anna McIntyre, APN

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1194118588
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1194551168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 US HIGHWAY 64",
            "city": "WHITEVILLE",
            "state": "TN",
            "postal_code": "380757461",
            "telephone_number": "731-254-8999",
            "fax_number": "731-254-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 US HIGHWAY 64",
            "city": "WHITEVILLE",
            "state": "TN",
            "postal_code": "380757461",
            "telephone_number": "731-254-8999",
            "fax_number": "731-254-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEVILLE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "LOCKHART",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "901-483-5370"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Mark Mangle, D.O., D.P.M.
• Tasma Graham Robertson, DNP. NP-C, PMHNP-BC
• Tarita Gifted Handz
• Wee Care ABA
• Whiteville Family Medical Clinic, LLC
• Whiteville Medical Clinic, LLC

• Family Medicine Physician in Whiteville, TN
• Providers in Whiteville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.