Paulo R.T. Yen

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

DPM336 Issued in TN

Legal business name

PAULO R.T. YEN

Doing business as

dba TLC Family Footcare

Practice address

1823 Memorial Dr
Clarksville, TN 37043-4604

Phone

(931) 648-9852

Fax

(931) 906-8528

NPI assigned

Mar 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paulo R.T. Yen, D.P.M.NPI 1982621603

Title

Owner

Phone

(931) 648-9852

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• dba TLC Family Footcare Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Paulo R.T. Yen, D.P.M.

  • Foot Surgery Podiatrist
  • Clarksville, TN
  • NPI 1982621603

  O20100930003841

  Same enrollment

Locations

Practitioners 1

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

• Paulo R.T. Yen, D.P.M.

  • Foot Surgery Podiatrist
  • Clarksville, TN
  • NPI 1982621603
  NPD Authorized official

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

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204329600000",
    "number": "1225208689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434604",
            "telephone_number": "931-648-9852",
            "fax_number": "931-906-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434604",
            "telephone_number": "931-648-9852",
            "fax_number": "931-906-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULO R.T. YEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-01",
        "last_updated": "2008-03-01",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "PAULO",
        "authorized_official_middle_name": "R.T.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-648-9852",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "TN",
            "license": "DPM336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3351486",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "4109056",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba TLC Family Footcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kaitlin D Pavon
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• Laura Payne
• Tamika Payne
• Alyssa Paz

• Podiatric Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Podiatric Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; 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.