Organization Active NPI

Lobelville Clinic

  • Family Medicine Physician
  • Lobelville, TN
National Provider Identifier
1194923029
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LOBELVILLE CLINIC
Practice address
236 North Main St
Lobelville, TN 37097
Phone
(931) 593-2277
Fax
(931) 593-2517
NPI assigned
Jul 3, 2007
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Mrs. Becky S Cunningham, OFFICE MGR.
Title
Office MGR.
Phone
(931) 593-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

236 North Main St
Lobelville, TN 37097

Mailing address

PO Box 219
236 North Main St.
Lobelville, TN 37097-0219
Phone (931) 593-2277

Other identifiers 1

IdentifierTypeStateIssuer
3303612MedicaidTN

Other names 1

  • Kenneth Salhany dba Lobelville Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001826 TN Part B Supplier - Clinic/Group Practice 5597751263 Receives reassigned benefits from 1 practitioner
Practice locations: Lobelville, 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
44D0704000Lobelville Clinic236 N Main St, Lobelville, TN 37097Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1194923029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "address_2": "236 NORTH MAIN ST.",
            "city": "LOBELVILLE",
            "state": "TN",
            "postal_code": "370970219",
            "telephone_number": "931-593-2277",
            "fax_number": "931-593-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 NORTH MAIN ST",
            "city": "LOBELVILLE",
            "state": "TN",
            "postal_code": "37097",
            "telephone_number": "931-593-2277",
            "fax_number": "931-593-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOBELVILLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "931-593-2277",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OFFICE MGR."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303612",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth Salhany dba Lobelville Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lobelville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.