Northside Medical Professionals, P.C.
Organization Active NPI Family Medicine Physician · Columbia, TN
NPI 1295044097 · NPPES record last updated Sep 28, 2010
Key facts
- NPI
- 1295044097
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- NORTHSIDE MEDICAL PROFESSIONALS, P.C.
- Practice address
- 1605 Nashville Hwy
Ste. 200
Columbia, TN 38401-2071 - Phone
- (931) 540-4210
- Fax
- (931) 380-1202
- NPI assigned
- Sep 28, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Shawn Gentry, M.D.
- Title
- Coo
- Phone
- (931) 540-4210
Practitioners 32
-
Casandra Ban, FNP
-
Belinda K Bart, M.D.
-
Christy M Cone, NP
-
Niccole Renea Crowley, F-NP
-
Shawn N Gentry, M.D.
-
Jennifer Renee Hill, APRN
-
Lindsey Hill, NP-C
-
Terri Christine Lacher, APRN
-
Angela McCally, FNP
-
Margaret Kimberly Murdock, FNP-C
-
Jennifer Marianne Rikard, NP-C
-
Allison I Simon, APRN
-
Christy Stapleton, FNP
-
Regina Ann Walters, APRN, FNP- C
-
Linda P Monroe, M.D.
-
John Novak, PA
-
Kristy D Yentes, FNP-BC, NP-C
-
Jeffie H Cherry, FNP
-
Crystal Dawn Clark, FNP-BC
-
Belinda Gail Romer, RN, NP
-
Sarah D Surber, APRN-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0912746 | Northside Medical Professionals PC | Provider-performed microscopy | Mar 10, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101201000188 | TN | Part B Supplier - Clinic/Group Practice | 8224224357 |
Receives reassigned benefits from 31 practitioners Practice locations: Columbia, TN; Lawrenceburg, TN; Lewisburg, TN |
National Provider Directory
Locations
2656 Highway 43 N
Lawrenceburg, TN 38464
Phone (931) 540-4210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Pediatrics Physician |
208000000X | |||
| Physician Assistant |
363A00000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
1605 Nashville Hwy
Ste. 200
Columbia, TN 38401-2071
Mailing address
1605 Nashville Hwy
Ste. 200
Columbia, TN 38401-2071
Phone (931) 540-4210
Other providers in Columbia, TN
- Carol Nixon
- Phyllis Ann Nobles
- Melissa Nolan
- Theresa Norris
- Northland Hearing Center, Inc.
- John Novak
- Johnny S. Nowlin
- Steven K Nowlin
- NPK Wellness & Beauty LLC
- Elizabeth Ann Null
All providers in Columbia, TN · Family Medicine 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 Sep 28, 2010. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.