Elderberry Health PLLC

Organization Active NPI Rural Health Clinic/Center · Oneida, TN

NPI 1619974581 · NPPES record last updated Nov 6, 2025

Key facts

NPI
1619974581
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ELDERBERRY HEALTH PLLC
Practice address
189 Andrew St
Oneida, TN 37841-6296
Phone
(423) 569-3762
Fax
(423) 569-4909
NPI assigned
Jul 7, 2005
Organization subpart
No

Authorized official

Name
Dr. Peter Michael Litchfield
Title
Physician
Phone
(629) 289-3136

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 8

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0961832Circle of Life Obstetrics and Family Care, PLLC
189 Andrew Drive, Oneida, TN 37841
Provider-performed microscopyJun 17, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN

Rural health clinic certification: CCN 448995

Legal name
ELDERBERRY HEALTH PLLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 8, 2018
Last certification
Aug 8, 2018
Ownership / control type
1A
Organization structure
LLC · Proprietary
Incorporated
Jul 1, 1991 in TN
Enrollment address
189 Andrew St
Oneida, TN 37841-6296

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peter Michael Litchfield
Individual
5% Or Greater Direct Ownership Interest
Ceo
Dec 21, 2023 100%
W-2 Managing Employee Dec 21, 2023 100%
Operational/Managerial Control Dec 21, 2023 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041014001206 TN Part B Supplier - Clinic/Group Practice 4486614302 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
Practice locations: Ashland City, TN
O20180124000634 TN Part a Provider - Rural Health Clinic 4486614302 Practice locations: Oneida, TN

National Provider Directory

Locations

16771 Alberta St
Oneida, TN 37841

189 Andrew St
Oneida, TN 37841
Phone (423) 569-3276

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 26733 TN
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

189 Andrew St
Oneida, TN 37841-6296

Mailing address

PO Box 23736
Nashville, TN 37202-3736
Phone (629) 289-3136

Other identifiers

IdentifierTypeStateIssuer
65933152MedicaidKY
3717532MedicaidTN

Other names

  • Circle of Life Obstetrics and Family Care, PLLC Former legal business name
  • John P Martin MD and Catherine S Martin DO Other name

Other providers in Oneida, TN

All providers in Oneida, TN · Rural Health Clinic/Center in Tennessee

Sources for this page

Verify at the official NPI Registry.