Andrea Clayton Bain, APNC
Individual provider Active NPI Family Nurse Practitioner · Leoma, TN
NPI 1669815759 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1669815759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 17544 (TN)
- Practice address
- 2367 Highway 43 S
Leoma, TN 38468-5209 - Phone
- (931) 766-2027
- Fax
- (855) 576-2925
- NPI assigned
- Apr 9, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aandm Medical Clinic LLC
Practice addresses (Care Compare)
2367 Hwy 43 S
Leoma, TN 38468-5209
Phone (931) 629-9644
Hospital & facility affiliations
- Southern Tennessee Regional Health System Lawrence
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140609000576 | TN | Practitioner - Nurse Practitioner | 0446474613 | Reassigns benefits to 2 organizations |
| I20160928001537 | AL | Practitioner - Nurse Practitioner | 0446474613 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Express Med of Alabama LLC | Current |
Accepting new patients | |
| A&M Medical Clinic LLC | Current |
Accepting new patients |
Locations
970 Cox Creek Pkwy
Florence, AL 35633
Phone (256) 760-1655
726 N Locust Ave
Ste 1D
Lawrenceburg, TN 38464
Phone (931) 766-7056
2367 Highway 43 S
Leoma, TN 38468
Phone (931) 629-9644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17544 | TN | Yes |
Addresses
Primary practice location
2367 Highway 43 S
Leoma, TN 38468-5209
Mailing address
PO Box 435
Lawrenceburg, TN 38464-0435
Phone (931) 766-2027
Other providers in Leoma, TN
All providers in Leoma, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.