NPIMap

Organization Active NPI

Madison Family Practice

  • Rural Health Clinic/Center
  • Jackson, TN
National Provider Identifier
1407086101
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MADISON FAMILY PRACTICE
Practice address
621 Old Hickory Blvd
Suite G
Jackson, TN 38305-2907
Phone
(731) 660-6402
Fax
(731) 660-6402
NPI assigned
Jul 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Heather N McFarland, NPNPI 1811028475
Title
Owner
Phone
(731) 660-6402

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

621 Old Hickory Blvd
Suite G
Jackson, TN 38305-2907

Mailing address

621 Old Hickory Blvd
Suite G
Jackson, TN 38305-2907
Phone (731) 660-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100824000354 TN Part B Supplier - Clinic/Group Practice 5991829228 Receives reassigned benefits from 6 practitioners
Practice locations: Jackson, TN; Lexington, TN; Medina, TN
O20130910000966 TN Part A Provider - Rural Health Clinic 5991829228 Practice locations: Lexington, TN
O20160824002326 TN Part A Provider - Rural Health Clinic 5991829228 Practice locations: Medina, TN

Rural health clinic certification: CCN 448924

Legal name
MADISON FAMILY PRACTICE
Doing business as
LEXINGTON FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 29, 2013
Last certification
Feb 5, 2026
Ownership / control type
1A
Organization structure
OtherProprietary
Enrollment address
524 S Broad St
Lexington, TN 38351-2202

Rural health clinic certification: CCN 448972

Legal name
MADISON FAMILY PRACTICE
Doing business as
MEDINA FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 10, 2016
Last certification
May 19, 2025
Ownership / control type
1A
Organization structure
OtherProprietary
Enrollment address
605 Hwy 45E S
Medina, TN 38355-1507

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2022367Medina Family Practice605 Hwy 45 Bypass South, Medina, TN 38355Certificate of waiverJan 13, 2027
44D2054120Lexington Family Practice524 South Broad St, Lexington, TN 38351Certificate of waiverSep 2, 2027

National Provider Directory

National Provider Directory

Locations

621 Old Hickory Blvd
Ste G
Jackson, TN 38305
Phone (731) 660-6402

621 Old Hickory Blvd
Jackson, TN 38305

524 S Broad St
Lexington, TN 38351
Phone (731) 651-0300

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Heather N McFarland Individual 5% Or Greater Direct Ownership Interest May 20, 2013
5% Or Greater Direct Ownership InterestOwner Aug 23, 2011
Janet Newsom Individual Operational/Managerial Control Nov 1, 2009
W-2 Managing Employee Nov 2, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1407086101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 OLD HICKORY BLVD",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052907",
            "telephone_number": "731-660-6402",
            "fax_number": "731-660-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 OLD HICKORY BLVD",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052907",
            "telephone_number": "731-660-6402",
            "fax_number": "731-660-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "MCFARLAND",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-660-6402",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.