Organization Active NPI

Motley Family Medical PLLC

  • Family Medicine Physician
  • Smyrna, TN
National Provider Identifier
1467015180
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOTLEY FAMILY MEDICAL PLLC
Doing business as
Motley Family Medical PLLC
Practice address
301 Wolverine TRL Ste 201
Smyrna, TN 37167-5656
Phone
(615) 768-5511
Fax
(615) 768-5519
NPI assigned
Apr 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Lucinda Motley, FNP-C
Title
Owner
Phone
(615) 768-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

301 Wolverine TRL Ste 201
Smyrna, TN 37167-5656

Mailing address

301 Wolverine TRL Ste 201
Smyrna, TN 37167-5656
Phone (615) 768-5511

Other identifiers 1

IdentifierTypeStateIssuer
1523655MedicaidTN

Other names 1

  • Motley Family Medical PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190627000996 TN Part B Supplier - Clinic/Group Practice 3072847813 Receives reassigned benefits from 2 practitioners
Practice locations: Smyrna, TN

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
44D2165769Motley Family Medical PLLC301 Wolverine Trail Ste 201, Smyrna, TN 37167Certificate of waiverMay 5, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1467015180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 WOLVERINE TRL STE 201",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675656",
            "telephone_number": "615-768-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WOLVERINE TRL STE 201",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675656",
            "telephone_number": "615-768-5511",
            "fax_number": "615-768-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTLEY FAMILY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "MOTLEY",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-768-5511",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523655",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Motley Family Medical PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.