Jacksboro Urgent Care LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

JACKSBORO URGENT CARE LLC

Doing business as

LaFollette Urgent Care

Practice address

2130 N Charles G Seivers Blvd Ste 3
Clinton, TN 37716-6705

Phone

(423) 437-8576

Fax

(423) 437-8556

NPI assigned

Sep 1, 2020

Last updated

Jul 25, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

JACKSBORO URGENT CARE LLCAs reported in NPPES

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

Authorized official

Name

Patricia Ann EberharterNPI 1841514957

Title

Chief Officer/Owner

Phone

(423) 907-8186

Specialties & licenses 1

Addresses

Other names 2

• LaFollette Urgent Care Doing business as
• Norris-Clinton Urgent Care Other name

Tax ID family

Jacksboro Urgent Care2 organizations share this tax ID, including this one

Part of

Jacksboro Urgent Care

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jacksboro Urgent Care

  • Urgent Care Clinic/Center
  • Jacksboro, TN
  • NPI 1629536362
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jacksboro Urgent Care

  • Urgent Care Clinic/Center
  • Jacksboro, TN
  • NPI 1629536362
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Ann Eberharter, FNP-BC

  • Family Nurse Practitioner
  • Jacksboro, TN
  • NPI 1841514957
  NPD Authorized official

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1346854064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 JACKSBORO PIKE STE 2",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377572752",
            "telephone_number": "423-437-8576",
            "fax_number": "423-437-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 N CHARLES G SEIVERS BLVD STE 3",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166705",
            "telephone_number": "423-437-8576",
            "fax_number": "423-437-8556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "LA Follette",
            "state": "TN",
            "postal_code": "377663617",
            "country_code": "US",
            "telephone_number": "423-437-8612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSBORO URGENT CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSBORO URGENT CARE LLC",
        "enumeration_date": "2020-09-01",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "EBERHARTER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF OFFICER/OWNER",
        "authorized_official_telephone_number": "423-907-8186"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaFollette Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Norris-Clinton Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie Jensen Huguley, LMSW
• Lauren Iles, PTA
• Independent Physical Therapy
• Teri L Ingle, FNP
• Dennis Jay Insell, PHARMD
• Alexandra J James, SLP
• Kenia C Jennings, OTR/L
• Jana Renee Johnson, CNA
• Miranda Jean Johnson, DPH
• Rachel Johnson, SLP

• Urgent Care Clinic/Center in Clinton, TN
• Providers in Clinton, TN by specialty
• Urgent Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.