CCS Care Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CCS CARE CLINIC LLC

Practice address

1409 Hatcher LN
Columbia, TN 38401-3535

Phone

(931) 446-5778

NPI assigned

Jun 26, 2025

Last updated

Feb 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Clark, FNP-BCNPI 1457195380

Title

Owner

Phone

(931) 446-5778

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Crystal Dawn Clark, FNP-BC

  • Family Nurse Practitioner
  • Columbia, TN
  • NPI 1457195380
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1649168790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013535",
            "telephone_number": "931-446-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCS CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-26",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-446-5778",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Renee Castaneda-Clark
• Josiedith Castaneda
• Karol Ann Cathey
• Vincent Salvatore Cavaliere
• Elizabeth Frances Cazan, PHARMD.
• Cedar Recovery Center of Middle Tennessee, LLC
• Cedar Recovery of Middle Tennessee, LLC (CedarRx-Columbia)
• Kevin J Cefali, AT
• Center for Dental Health
• Center for Sleep and Snoring, LLC

• Family Nurse Practitioner in Columbia, TN
• Providers in Columbia, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.