NPIMap

Organization Active NPI

Rural Health Clinics of West TN, PLLC

  • Legal Medicine
  • Dyersburg, TN
National Provider Identifier
1619202322
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
RURAL HEALTH CLINICS OF WEST TN, PLLC
Practice address
1716 Parr Ave
Ste a
Dyersburg, TN 38024-2073
Phone
(731) 285-3300
Fax
(731) 285-3370
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Ms. Pat F Owen
Title
Practice Manager
Phone
(731) 286-0149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X Primary

Addresses

Primary practice location

1716 Parr Ave
Ste a
Dyersburg, TN 38024-2073

Mailing address

PO Box 1209
Dyersburg, TN 38025-1209
Phone (731) 286-0149

Other identifiers 1

IdentifierTypeStateIssuer
3730286MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Rural Health Clinics of West TN PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1619202322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380251209",
            "telephone_number": "731-286-0149",
            "fax_number": "731-286-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 PARR AVE",
            "address_2": "STE A",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242073",
            "telephone_number": "731-285-3300",
            "fax_number": "731-285-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH CLINICS OF WEST TN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "PAT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "731-286-0149",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3730286",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.