Mobile Medical Clinic PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

MOBILE MEDICAL CLINIC PLLC

Practice address

404 Castle Heights Ave N
Suite E
Lebanon, TN 37087-1511

Phone

(615) 449-7002

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Craig E Dean, PANPI 1386639383

Title

Owner

Phone

(615) 449-7002

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

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

• Craig Edward Dean, PA C

  • Physician Assistant
  • Murfreesboro, TN
  • NPI 1386639383
  NPD (past) Authorized official
• Amy L Powers, APRN

  • Family Nurse Practitioner
  • Lebanon, TN
  • NPI 1891780896
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1275567125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370880158",
            "telephone_number": "615-449-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CASTLE HEIGHTS AVE N",
            "address_2": "SUITE E",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871511",
            "telephone_number": "615-449-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-449-7002",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3907834",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Austin Mitchell Jr., MD
• Elizabeth Kay Mitchell, M.D.
• Jade Tierra Mitchell, PH.D.
• Sharon Shaye Mitchell, RN
• Sarah Beidler Moats, DPT
• Robert Cleland Monaghan II, PHARMD
• August Deshae Montgomery
• Tequeila Cherie Moon, LMSW
• Euclid Darryl Moore, DDS
• James Mark Moore, PHARMD

• Physician Assistant in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.