Mountain Bend Medical Associates PLLC
Organization Active NPI Primary Care Clinic/Center · Dunlap, TN
NPI 1497515225 · NPPES record last updated Feb 2, 2026
Key facts
- NPI
- 1497515225
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- MOUNTAIN BEND MEDICAL ASSOCIATES PLLC
- Practice address
- 29 Crestview Drive
Dunlap, TN 37327-7039 - Phone
- (423) 949-6300
- Fax
- (423) 949-6374
- NPI assigned
- Mar 20, 2024
- Organization subpart
- No
Authorized official
- Name
- Samantha Graham
- Title
- Office Manager
- Phone
- (423) 949-6300
Practitioners 7
-
Caleb M May, D.O.
-
Tarrah Davis, FNP-C
-
Debora Joan Angel-Pompi, N.P.
-
Jessica Dion Shedd, NP-C
-
Bradley K Hatcher, NP-C
-
Angela Maria Snyder, MSN, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0898724 | Mountain Bend Medical Associates | Certificate of waiver | Mar 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240618001957 | TN | Part B Supplier - Clinic/Group Practice | 2567905607 |
Receives reassigned benefits from 1 practitioner Practice locations: Dunlap, TN |
National Provider Directory
Locations
15166 Rankin Ave
Dunlap, TN 37327
Phone (423) 949-6300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
29 Crestview Drive
Dunlap, TN 37327-7039
Mailing address
PO Box 1389
Dunlap, TN 37327-1389
Phone (423) 949-6300
Other providers in Dunlap, TN
- Patti Carlene Mayfield
- 0Susan Kelly Merriman
- Kasey Leann Mills
- David L Morrison
- Jason Moss
- Marly Coleman Myrick
- NHC Healthcare Sequatchie LLC
- NHC Healthcare-Sequatchie LLC
- Kenneth Nix
- Northland Hearing Center, Inc.
All providers in Dunlap, TN · Primary Care Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.