Moscow Family Medical,LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MOSCOW FAMILY MEDICAL,LLC

Practice address

13775 Highway 57 Ste 4
Moscow, TN 38057-3802

Phone

(901) 877-3070

NPI assigned

Jun 5, 2019

Last updated

Jun 18, 2019By 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

Mrs. Zelma Allen, NPNPI 1568711638

Title

Owner

Phone

(901) 877-3070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19937/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Zelma Allen, FNP-C

  • Family Nurse Practitioner
  • Holly Springs, MS
  • NPI 1568711638

  TN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1548828304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13775 HIGHWAY 57 STE 4",
            "city": "MOSCOW",
            "state": "TN",
            "postal_code": "380573802",
            "telephone_number": "901-877-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13775 HIGHWAY 57 STE 4",
            "city": "MOSCOW",
            "state": "TN",
            "postal_code": "380573802",
            "telephone_number": "901-877-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSCOW FAMILY MEDICAL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ZELMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-877-3070",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shan McLean, RN, IBCLC
• Porter Place Rehab and Fitness LLC (Porter Place Rehab & Fitness)
• Renata Walton
• WLR Enterprise Inc

• Family Nurse Practitioner in Moscow, TN
• Providers in Moscow, 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 Jun 18, 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.