NPIMap

Organization Active NPI

McKenzie Medical Center, PC

Doing business as Hometown Health Clinic Greenfield

  • Rural Health Clinic/Center
  • Greenfield, TN
National Provider Identifier
1437040128
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MCKENZIE MEDICAL CENTER, PC
Doing business as
Hometown Health Clinic Greenfield
Practice address
1731 S Meridan Street
Greenfield, TN 38230-1827
Phone
(731) 352-7907
Fax
(833) 690-3848
NPI assigned
Jul 11, 2025
Last updated
Jun 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Tammy Etheridge
Title
Coo
Phone
(731) 352-7907

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Clinic/Center 261Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

1731 S Meridan Street
Greenfield, TN 38230-1827

Mailing address

205A Hospital Dr
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other names 1

  • Hometown Health Clinic Greenfield Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040619000083 TN Part B Supplier - Clinic/Group Practice 2365427853 Receives reassigned benefits from 34 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Trenton, TN; McKenzie, TN; MC Kenzie, TN; Huntingdon, TN; Gleason, TN; Dresden, TN; Camden, TN; Bruceton, TN…
O20250930004283 TN Part A Provider - Rural Health Clinic 2365427853 1 other NPI on this enrollment
Practice locations: Greenfield, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437040128. Details of each certification follow.

Rural health clinic certification: CCN 888945

Legal name
MCKENZIE MEDICAL CENTER PC
Doing business as
HOMETOWN HEALTH CLINIC GREENFIELD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 18, 2025
Last certification
Dec 18, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Enrollment address
1731 S Meridian St
Greenfield, TN 38230-1827

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
McKenzie Medical Center10 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.

Locations

306 Highway 641 N
Ste A
Camden, TN 38320

811 Morrow St
Ste 207
Dresden, TN 38225
Phone (731) 364-4900

205 Court Sq
#A
Huntingdon, TN 38344
Phone (731) 535-5765

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
Bryan Hale Merrick Individual 5% Or Greater Direct Ownership InterestOwner Aug 4, 2025 50%
Corporate DirectorOwner Aug 4, 2025 50%
W-2 Managing EmployeeAd; Aug 4, 2025 50%
Terry Andrew Colotta Individual 5% Or Greater Direct Ownership InterestOwner Aug 4, 2025 50%
Corporate DirectorOwner Aug 4, 2025 50%
W-2 Managing EmployeeMD; Aug 4, 2025 50%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1752192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1437040128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205A HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "833-690-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 S MERIDAN STREET",
            "city": "GREENFIELD",
            "state": "TN",
            "postal_code": "382301827",
            "telephone_number": "731-352-7907",
            "fax_number": "833-690-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-11",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "ETHERIDGE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "731-352-7907"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Health Clinic Greenfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hometown Health Clinic Greenfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, TN

Sources for this page

Verify at the official NPI Registry.