Organization Active NPI

Medical Clinic of Lewisburg LLC

  • Family Nurse Practitioner
  • Lewisburg, TN
National Provider Identifier
1609109222
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MEDICAL CLINIC OF LEWISBURG LLC
Practice address
122 E Commerce St
Lewisburg, TN 37091-3340
Phone
(931) 675-9032
NPI assigned
Sep 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Dr. Louis A Shone III
Title
Manager
Phone
(931) 675-9032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

122 E Commerce St
Lewisburg, TN 37091-3340

Mailing address

PO Box 2425
Lewisburg, TN 37091-1425

National Provider Directory

National Provider Directory

Locations

122 E Commerce St
Lewisburg, TN 37091
Phone (615) 814-3400

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1609109222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2425",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370911425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E COMMERCE ST",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370913340",
            "telephone_number": "931-675-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CLINIC OF LEWISBURG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "SHONE",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "931-675-9032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.