Tennessee Convenience Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18488 Issued in TN

Legal business name

TENNESSEE CONVENIENCE CARE LLC

Practice address

315 N Washington Ave Ste 130
Cookeville, TN 38501-2623

Phone

(931) 526-1050

Fax

(931) 526-8163

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Lora F Elkins

Title

Ceo

Phone

(931) 526-1050

Specialties & licenses 3

Addresses

Other names 1

• Tennessee Convenience Care Doing business as

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1376937797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON AVE STE 130",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012623",
            "telephone_number": "931-526-1050",
            "fax_number": "931-526-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON AVE STE 130",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012623",
            "telephone_number": "931-526-1050",
            "fax_number": "931-526-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CONVENIENCE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "ELKINS",
        "authorized_official_first_name": "LORA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-526-1050"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "18488",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17011",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "13278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennessee Convenience Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.