Kaful Double Portion Family Practice, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000014265 Issued in TN

Legal business name

KAFUL DOUBLE PORTION FAMILY PRACTICE, INC

Practice address

3740 Ocoee Place NW
Suite 101
Cleveland, TN 37312

Phone

(423) 339-7107

Fax

(423) 339-6717

NPI assigned

Oct 31, 2014

Last updated

Dec 22, 2014By 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

Brenda Gilbert, NPNPI 1811127137

Title

Provider/Owner

Phone

(423) 339-7107

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 16

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.

• Brenda L Gilbert, APN

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1811127137
  Medicare reassignment Care Compare group NPD Authorized official
• Gerard K Mazza, MD

  • Family Medicine Physician
  • Cleveland, TN
  • NPI 1568504918
  Medicare reassignment Care Compare group NPD
• Brooke Denise Booher, APRN, FNP-C

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1306462478
  Medicare reassignment NPD
• Susanne Clark, NP

  • Nurse Practitioner
  • Cleveland, TN
  • NPI 1609648021
  Medicare reassignment NPD
• Jennifer P Fontenot, DNP, APRN, NP-C

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1427288422
  Medicare reassignment NPD
• Caroline Elisabeth Gates, NP-C

  • Family Nurse Practitioner
  • Hixson, TN
  • NPI 1699047894
  Medicare reassignment NPD
• Rachel Harwood, DNP, FNP-C

  • Family Nurse Practitioner
  • Ocoee, TN
  • NPI 1154079242
  Medicare reassignment NPD
• Victoria L Kinsey, DO

  • Family Medicine Physician
  • Benton, TN
  • NPI 1225023799
  Medicare reassignment NPD
• Mary Christy Lipscomb, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • East Ridge, TN
  • NPI 1790127090
  Medicare reassignment NPD
• Tiundra Leshaun Love, D.O.

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1376787788
  Medicare reassignment NPD
• Laurel Martin, NP

  • Family Nurse Practitioner
  • Benton, TN
  • NPI 1205467339
  Medicare reassignment NPD
• Tyler Keith McCurry, D.O.

  • General Practice Physician
  • Cleveland, TN
  • NPI 1700129244
  Medicare reassignment NPD

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1386049476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 OCOEE PLACE NW",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-339-7107",
            "fax_number": "423-339-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 OCOEE PLACE NW",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-339-7107",
            "fax_number": "423-339-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAFUL DOUBLE PORTION FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "423-339-7107",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000014265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura H Justiss, MFTA
• K VA T Food Stores Inc (Food City Pharmacy #739)
• K VA T Food Stores, Inc. (Food City Pharmacy #712)
• K-VA-T Food Stores, Inc (Food City Pharmacy #743)
• Emily Kabilus, RN
• Kah Development 8, LLC (Gentiva I)
• Samantha Macchio Kapperman, OD
• Karin Moore
• Karis Community Health
• Shobha Karwan, MD

• Family Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.