Organization Active NPI

Cumberland Family Care PC

  • Family Medicine Physician
  • Sparta, TN
National Provider Identifier
1225003809
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CUMBERLAND FAMILY CARE PC
Practice address
457 Vista Dr
Sparta, TN 38583-1360
Phone
(931) 738-3383
Fax
(931) 738-8911
NPI assigned
Feb 17, 2006
Last updated
Jul 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Authorized official

Name
Mischelle Lynn Ferrell, MHA
Title
Practice Administrator
Phone
(931) 738-3383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

457 Vista Dr
Sparta, TN 38583-1360

Mailing address

457 Vista Dr
Sparta, TN 38583-1360
Phone (931) 738-3383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041110000115 TN Part B Supplier - Clinic/Group Practice 8729041835 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Sparta, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
44D0857831Cumberland Family Care PC457 Vista Drive, Sparta, TN 38583Provider-performed microscopyFeb 29, 2028

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFAD

Practitioners & affiliated clinicians

Practitioners 7

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": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467331200000",
    "number": "1225003809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 VISTA DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831360",
            "telephone_number": "931-738-3383",
            "fax_number": "931-738-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 VISTA DR",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831360",
            "telephone_number": "931-738-3383",
            "fax_number": "931-738-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-07-01",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "MISCHELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "931-738-3383",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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.