Afc Physicians of Tennessee, PC
Organization Active NPI General Practice Physician · Smyrna, TN
NPI 1285937003 · NPPES record last updated Jun 12, 2020
Key facts
- NPI
- 1285937003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- AFC PHYSICIANS OF TENNESSEE, PC
- Practice address
- 985 Industrial Blvd
Smyrna, TN 37167-6815 - Phone
- (615) 220-8500
- Fax
- (615) 220-8504
- NPI assigned
- Dec 16, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- AFC PHYSICIANS OF TENNESSEE, PC
Authorized official
- Name
- Mr. Randy Johansen
- Title
- President
- Phone
- (205) 421-2102
Other NPIs on the same Medicare enrollment 6
Practitioners 6
-
Jonathan M Head, MD
-
Brian E. Ingalls, MD
-
Robert Lewis Kite, FNP-BC
-
Sushri M Mishra, MD
-
Mallory Walters Newton, PA-C
-
Joseph Duane Payne, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110128000880 | TN | Part B Supplier - Clinic/Group Practice | 5395924823 |
Receives reassigned benefits from 114 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Knoxville, TN; Spring Hill, TN; Smyrna, TN; Nashville, TN; Hendersonville, TN; Clarksville, TN; Chattanooga, TN; Mt. Juliet, TN… |
National Provider Directory
- Part of
- Afc Physicians of Tennessee
Locations
3520 Cummings Hwy
Chattanooga, TN 37419
Phone (423) 822-5942
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | TN | Yes |
Addresses
Primary practice location
985 Industrial Blvd
Smyrna, TN 37167-6815
Mailing address
3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103G702075 | Other | TN | MEDICARE GROUP IDENTIFIER |
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All providers in Smyrna, TN · General Practice Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.