Family Clinic of Selmer, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY CLINIC OF SELMER, PC

Practice address

832 Mulberry Ave Ste B
Selmer, TN 38375-2334

Phone

(731) 434-0201

Fax

(731) 434-0203

NPI assigned

Nov 18, 2019

Last updated

Jan 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Jane Dickey, MD

Title

Owner

Phone

(731) 607-7484

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1487290110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 MULBERRY AVE STE B",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752334",
            "telephone_number": "731-434-0201",
            "fax_number": "731-434-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 MULBERRY AVE STE B",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752334",
            "telephone_number": "731-434-0201",
            "fax_number": "731-434-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CLINIC OF SELMER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-607-7484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q053134",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Selmer, TN
• Providers in Selmer, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.