Willow Medical Clinic, LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

WILLOW MEDICAL CLINIC, LLC

Practice address

1400 Willow Dr
Manchester, TN 37355-2438

Phone

(931) 728-7677

Fax

(931) 728-7066

NPI assigned

Jul 29, 2008

Last updated

Jul 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tammy Shelley

Title

Office Manager/Assist. Business Adm

Phone

(931) 570-4755

Specialties & licenses 2

Addresses

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.

• David G Florence, DO

  • Family Medicine Physician
  • Manchester, TN
  • NPI 1881676856
  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1356507404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1223",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373491223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WILLOW DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552438",
            "telephone_number": "931-728-7677",
            "fax_number": "931-728-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER/ASSIST. BUSINESS ADM",
        "authorized_official_telephone_number": "931-570-4755",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macie Gray Walker, PHARMD
• Michelle Taylor Watts, PA
• Katherine Corrin Webb
• Amy B White, APN
• Whole Family Clinic, PLLC
• Willow Medical, LLC
• Willow Pediatric Clinic, LLC
• Sarah Schwartz Wilson, M.D.
• Laurie Winton, LPC-MHSP
• Dustin Taylor Wiseman

• Medical Physician Assistant in Manchester, TN
• Providers in Manchester, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.