Acne & Rosacea Clinics

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN8135 Issued in TN

Legal business name

ACNE & ROSACEA CLINICS

Practice address

907 Vann Drive Suite M
Jackson, TN 38305-6046

Phone

(731) 668-5000

Fax

(731) 668-5122

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Mary Beth Cox, FNP

Title

Owner

Phone

(731) 668-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1356593545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 VANN DRIVE STE M",
            "address_2": "PO BOX 11537",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "380126046",
            "telephone_number": "731-668-5000",
            "fax_number": "731-668-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 VANN DRIVE SUITE M",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056046",
            "telephone_number": "731-668-5000",
            "fax_number": "731-668-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACNE & ROSACEA CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-668-5000",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN8135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3906025",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carrie Anne Ackroyd, MSED
• Sonya Acuff
• Kaleb Adams
• Mary Allison Adams, RN
• Mary Lou Adams, NP
• Trista Nicole Adams, MS

• All providers in Jackson, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.