Individual provider Active NPI

Lexie Jean Modlin, NP

  • Family Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1689315046
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31398 Issued in TN
Practice address
2861 Teakwood Dr
Clarksville, TN 37040-1610
Phone
(706) 615-2618
NPI assigned
Apr 7, 2022
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31398 TN Primary
Registered Nurse 163W00000X 1659863 CO

Addresses

Primary practice location

2861 Teakwood Dr
Clarksville, TN 37040-1610

Mailing address

2861 Teakwood Dr
Clarksville, TN 37040-1610
Phone (706) 615-2618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220929000209 TN Practitioner - Nurse Practitioner 4981080926
I20241010002807 GA Practitioner - Nurse Practitioner 4981080926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2300 Manchester Expy
Suite A201
Columbus, GA 31904-6856
Phone (706) 320-2766

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1659863COMDRegistered Nurse
31398TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dino a Delaurentis DO PLLC CurrentSince Sep 1, 2022 Accepting new patients
Urology Center of Columbus, LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

1021 Talbotton Rd
Columbus, GA 31904
Phone (706) 322-0631

787 Weatherly Dr
Ste 400
Clarksville, TN 37043
Phone (931) 291-9150

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1689315046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 TEAKWOOD DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401610",
            "telephone_number": "706-615-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 TEAKWOOD DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401610",
            "telephone_number": "706-615-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODLIN",
        "first_name": "LEXIE",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31398",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1659863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.