Afc Physicians of Tennessee, PC
Organization Active NPI General Practice Physician · Clarksville, TN
NPI 1639508666 · NPPES record last updated Jun 12, 2020
Key facts
- NPI
- 1639508666
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- AFC PHYSICIANS OF TENNESSEE, PC
- Practice address
- 1763 Madison Street Commons
Clarksville, TN 37043 - Phone
- (931) 278-8000
- Fax
- (931) 278-8004
- NPI assigned
- Nov 12, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- AFC PHYSICIANS OF TENNESSEE, PC
Authorized official
- Name
- Mr. Randy Johansen
- Title
- President
- Phone
- (054) 212-1012
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 6
Practitioners 9
-
Jennifer Garey, MSN FNP-BC
-
Samuel J Perry, M.D.
-
Pamela J Sturgill, PA-C
-
Christopher A. Wells, MD, PHD
-
Colby Wisdom, PA-C
-
Tiffany S Coffman, FNP
-
Anthony Sloan, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110128000880 | TN | Part B Supplier - Clinic/Group Practice | 5395924823 |
Receives reassigned benefits from 114 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Knoxville, TN; Spring Hill, TN; Smyrna, TN; Nashville, TN; Hendersonville, TN; Clarksville, TN; Chattanooga, TN; Mt. Juliet, TN… |
National Provider Directory
- Tax ID family
- Afc Physicians of Tennessee
- Part of
- Afc Physicians of Tennessee
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | TN | Yes |
Addresses
Primary practice location
1763 Madison Street Commons
Clarksville, TN 37043
Mailing address
3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103G702075 | Other | TN | MCR PTAN |
Other providers in Clarksville, TN
- Advanced Diagnostic Imaging, PC
- Advanced Hearing Aid Group, LLC
- Advanced Physical Therapy & Rehab Services Inc
- Advanced Sleep Diagnostics, Inc.
- Advanced Therapy Solutions
- Affinity Integrated Care
- Affordable Dental Incorporated
- Affordable Dentures & Implants - Tennessee, PLLC
- Katerine Folashade Afolayan
- Agilitas USA, Inc
All providers in Clarksville, TN · General Practice Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.