Washington Ave Family Practice

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN 93501 Issued in TN

Legal business name

WASHINGTON AVE FAMILY PRACTICE

Practice address

67 N Washington Ave
Cookeville, TN 38501-3371

Phone

(931) 526-4004

Fax

(931) 526-4014

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Chris Hash

Title

Office Manager

Phone

(931) 526-4004

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1447449533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385030702",
            "telephone_number": "931-526-4004",
            "fax_number": "931-526-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 N WASHINGTON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013371",
            "telephone_number": "931-526-4004",
            "fax_number": "931-526-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON AVE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "HASH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-526-4004",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "RN 93501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PRICING",
            "identifier": "3726167",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Lee Wallace, M.D.
• Natalie N Wallace
• William Jacob Wallace, PA
• Amy Catherine Ward, BS
• Tiffany Ward, FNP
• William Walter Wassynger, M.D.
• Mark Wathen, MD
• Jimmie Gregory Watkins, DPM
• Sharonda Watkins
• Shelby Watkins, PA-C

• Family Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, 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 Oct 15, 2007; 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.