Organization Active NPI

Union City Urgent Care LLC

  • Family Nurse Practitioner
  • Union City, TN
National Provider Identifier
1275698797
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0000106893 Issued in TN
Legal business name
UNION CITY URGENT CARE LLC
Practice address
1012 S Miles Ave
Union City, TN 38261-5432
Phone
(731) 885-8282
Fax
(731) 885-1998
NPI assigned
Dec 26, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Carla A Hoffman
Title
Office Manager
Phone
(731) 885-8282

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners 2

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

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
44D1039846Union City Urgent Care, LLC1012 S Miles Avenue, Union City, TN 38261Certificate of waiverApr 24, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050617000633 TN Part B Supplier - Clinic/Group Practice 3678517836 Receives reassigned benefits from 2 practitioners
Practice locations: Union City, TN
O20151210001606 TN Part a Provider - Rural Health Clinic 3678517836 Practice locations: Union City, TN

Rural health clinic certification: CCN 448959

Medicare enrollment files
Legal name
UNION CITY URGENT CARE LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 23, 2016
Last certification
Mar 27, 2024
Ownership / control type
1C
Organization structure
LLCProprietary
Enrollment address
1012 S Miles Ave
Union City, TN 38261-5432

All disclosed owners & managing parties 2

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ginger P Odle Individual 5% Or Greater Direct Ownership Interest Apr 1, 2005 50%
Operational/Managerial Control May 26, 2022 50%
Michael Chad Odle Individual 5% Or Greater Direct Ownership Interest Apr 1, 2005 50%
Operational/Managerial Control Apr 1, 2005 50%

National Provider Directory

National Provider Directory

Locations

1229 S 1st St
Union City, TN 38261
Phone (731) 885-8282

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 0000106893 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

1012 S Miles Ave
Union City, TN 38261-5432

Mailing address

PO Box 307
Union City, TN 38281-0307
Phone (731) 885-8282

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2025.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1275698797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382810307",
            "telephone_number": "731-885-8282",
            "fax_number": "731-885-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 S MILES AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615432",
            "telephone_number": "731-885-8282",
            "fax_number": "731-885-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION CITY URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-885-8282",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000106893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.