Cannon County Healthcare PC
Organization Active NPI Family Medicine Physician · Woodbury, TN
NPI 1386667244 · NPPES record last updated Jul 23, 2026
Key facts
- NPI
- 1386667244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD34850 (TN)
- Legal business name
- CANNON COUNTY HEALTHCARE PC
- Practice address
- 205 S McCrary St
Woodbury, TN 37190-1439 - Phone
- (615) 563-2891
- Fax
- (615) 563-4582
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeff Todd
- Title
- Physician Owner
- Phone
- (615) 563-2891
Practitioners 12
-
Rachel Martin, FNP
-
Monika Ewelina Safarpour, AGACNP-BC
-
Jeff Todd, MD
-
Abigail Jones, PA-C
-
Paula Todd, FNP
-
Sydney Hunt, FNP
-
Janice Bass, FNP
-
Suzanne Scoble, CFNP
-
Michael Auston Thomas, M.D.
-
Lauren Shurson, FNP-BC, RN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0307990 | Cannon Co Healthcare, PC | Certificate of waiver | Apr 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040611001490 | TN | Part B Supplier - Clinic/Group Practice | 5890778575 |
Receives reassigned benefits from 7 practitioners Practice locations: Woodbury, TN |
National Provider Directory
Locations
205 S McCrary St
Woodbury, TN 37190
Phone (615) 563-2891
225 S McCrary St
Woodbury, TN 37190
205 S McCrary St
Ste 1
Woodbury, TN 37190
Phone (615) 563-2891
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MD34850 | TN | Yes |
Addresses
Primary practice location
205 S McCrary St
Woodbury, TN 37190-1439
Mailing address
205 S McCrary St
Woodbury, TN 37190-1420
Phone (615) 563-2891
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3370878 | Medicaid | TN |
Other names
- Woodbury Medical Center
- Woodbury Medical Clinic
Other providers in Woodbury, TN
- Jessica Mae Cadle
- Amy L Campbell
- Cannon County Ambulance Service
- Cannon County Board of Education
- Cannon County Chiropractic, PLLC
- Cannon County Hospital LLC
- Cannon County Hospital LLC
- Cannon County Hospital LLC
- Cannon County Hospital LLC
- Cannon County Hospital LLC
All providers in Woodbury, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.