TLC Primary Care LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F0613640 Issued in TN

Legal business name

TLC PRIMARY CARE LLC

Practice address

9457 David Smith LN
Suite 105
Ooltewah, TN 37363-7292

Phone

(423) 362-7600

Fax

(423) 238-6565

NPI assigned

Aug 11, 2014

Last updated

Aug 11, 2014By 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

Prof. Donna R Duff, NP

Title

Sole Proprietor

Phone

(423) 362-7600

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1659780005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "address_2": "SUITE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-362-7600",
            "fax_number": "423-238-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9457 DAVID SMITH LN",
            "address_2": "SUITE 105",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637292",
            "telephone_number": "423-362-7600",
            "fax_number": "423-238-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "DUFF",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "423-362-7600",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN0000005112",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "F0613640",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "48915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

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