NPIMap

Organization Active NPI

Professional Care Services of West TN Inc

Doing business as JB Summers Counseling Center

  • Community/Retail Pharmacy
  • Somerville, TN
National Provider Identifier
1396801007
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2382 Issued in TN
Legal business name
PROFESSIONAL CARE SERVICES OF WEST TN INC
Doing business as
JB Summers Counseling Center
Practice address
12615 S Main
Somerville, TN 38068-1673
Phone
(901) 465-9831
Fax
(901) 465-8070
NPI assigned
Dec 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jim Causey, PHD
Title
Executive Director
Phone
(901) 476-8967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2382 TN Primary

Addresses

Primary practice location

12615 S Main
Somerville, TN 38068-1673

Mailing address

1997 Hwy 51 S
Covington, TN 38019-3630
Phone (901) 476-8967

Other identifiers 1

IdentifierTypeStateIssuer
4428252OtherNCPDP

Other names 1

  • JB Summers Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Services of West TN Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396801007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1997 HWY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-476-8967",
            "fax_number": "901-318-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 S MAIN",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380681673",
            "telephone_number": "901-465-9831",
            "fax_number": "901-465-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE SERVICES OF WEST TN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAUSEY",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-476-8967",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "2382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4428252",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JB Summers Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.