Superior Health and Wellness Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

15852 Issued in TN

Legal business name

SUPERIOR HEALTH AND WELLNESS CLINIC

Practice address

1463 S Highland Ave
Ste J
Jackson, TN 38301-7543

Phone

(731) 300-7410

Fax

(731) 300-7420

NPI assigned

Jan 15, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Britney L Petway, FNP-C

Title

Owner/Nurse Practitioner

Phone

(731) 300-7410

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1366809717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 S HIGHLAND AVE",
            "address_2": "STE J",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017543",
            "telephone_number": "731-300-7410",
            "fax_number": "731-300-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 S HIGHLAND AVE",
            "address_2": "STE J",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017543",
            "telephone_number": "731-300-7410",
            "fax_number": "731-300-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR HEALTH AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "PETWAY",
        "authorized_official_first_name": "BRITNEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "731-300-7410",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "15852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Jackson, TN
• Providers in Jackson, 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 Jan 4, 2017; 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.