Genesis Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GENESIS MEDICAL CLINIC LLC

Practice address

220 W Cedar St
Shelbyville, TN 37160-2838

Phone

(931) 684-4153

Fax

(888) 371-5180

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Alma M Tamula, MD

Title

Sole Proprietor Physician

Phone

(931) 684-4153

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1306016274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602838",
            "telephone_number": "931-684-4153",
            "fax_number": "888-371-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602838",
            "telephone_number": "931-684-4153",
            "fax_number": "888-371-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "TAMULA",
        "authorized_official_first_name": "ALMA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE PROPRIETOR PHYSICIAN",
        "authorized_official_telephone_number": "931-684-4153",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Danyel Frazier, MS, BCBA
• Victoria Ann Fung-a-Fat, PHARM.D.
• Mistdena Gardner, RN
• Mallory Garner, M.S.W.
• Laura Gayle Gartside
• Gerald T. Martin, D.D.S.
• Geriatric Psychology Affiliates LLC
• Geriatric Psychology Affiliates LLC
• Jordi Wessam Sabry Ghitany
• Lawanda Denise Gibbs, LMSW

• Primary Care Clinic/Center in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.