Family Care Center LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

MD30470 Issued in TN

Legal business name

FAMILY CARE CENTER LLC

Doing business as

Westside Family Care Center

Practice address

207 W Locust St
Lafayette, TN 37083-1710

Phone

(615) 666-6425

Fax

(615) 666-3261

NPI assigned

Aug 27, 2007

Last updated

Aug 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hanna C Ilia, MDNPI 1205826526

Title

Owner

Phone

(615) 666-6425

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Westside Family Care Center Doing business as

Practitioners 1

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.

• Hanna C Ilia, MD

  • Family Medicine Physician
  • Lafayette, TN
  • NPI 1205826526
  NPD Authorized official

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1194918755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10427 HIGHWAY 52 W",
            "city": "WESTMORELAND",
            "state": "TN",
            "postal_code": "371863234",
            "telephone_number": "615-644-5832",
            "fax_number": "615-644-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LOCUST ST",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831710",
            "telephone_number": "615-666-6425",
            "fax_number": "615-666-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "ILIA",
        "authorized_official_first_name": "HANNA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-666-6425",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "TN",
            "license": "MD30470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3828728",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G82303",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205826526",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Family Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Delk
• Jenna Renee Dillard, MA, BCBA
• Tammy Michelle Driver, RN
• Roger D. Ellis, D.C.
• Emcare Physician Providers, Inc.
• Family Care Center LLC
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC
• Jordain Paige Ferguson Barnett, DNP
• Kathryn Ann Fitzgerald, PHARM.D.

• Health Service Clinic/Center in Lafayette, TN
• Providers in Lafayette, TN by specialty
• Health Service Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.