Allardt Family Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ALLARDT FAMILY CARE LLC

Practice address

2009 Michigan Avenue
Allardt, TN 38504

Phone

(931) 303-6993

NPI assigned

Jun 26, 2020

Organization subpart

No

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

Authorized official

Name

Paul Roger Koger II, FNP-CNPI 1235659137

Title

Managing Member

Phone

(931) 752-9485

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

Practitioners 2

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

• Paul Roger Koger II, FNP-C

  • Family Nurse Practitioner
  • Allardt, TN
  • NPI 1235659137

  TN

  Medicare reassignment NPD Authorized official
• Joseph Payant

  • Family Medicine Physician
  • Jamestown, TN
  • NPI 1760422943
  NPD (past)

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1548887482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "ALLARDT",
            "state": "TN",
            "postal_code": "385040190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 MICHIGAN AVENUE",
            "city": "ALLARDT",
            "state": "TN",
            "postal_code": "38504",
            "telephone_number": "931-303-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLARDT FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "KOGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "931-752-9485",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dillon Mental Wellness Psychiatry, PLLC
• Tabatha Mechelle Dillon, MSN, APRN, PMHNP-BC
• Paul Roger Koger II, FNP-C
• Sherri Stinson, LCSW

• All providers in Allardt, TN
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.