Individual provider Active NPI

Dayne Gordon Poulton, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1508627308
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
37143 Issued in TN
Practice address
782 Weatherly Dr
Clarksville, TN 37043-8941
Phone
(931) 645-3552
NPI assigned
Jan 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 37143 TN Primary
Registered Nurse 163W00000X 273327 TN

Addresses

Primary practice location

782 Weatherly Dr
Clarksville, TN 37043-8941

Mailing address

782 Weatherly Dr
Clarksville, TN 37043-8941
Phone (931) 645-3552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
273327TNMDRegistered Nurse
37143TNMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1508627308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438941",
            "telephone_number": "931-645-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "782 WEATHERLY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438941",
            "telephone_number": "931-645-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULTON",
        "first_name": "DAYNE",
        "middle_name": "GORDON",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-18",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "37143",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "273327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.