Magnolia Family Medicine and Wellness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MAGNOLIA FAMILY MEDICINE AND WELLNESS

Practice address

1402 Willow Dr
Manchester, TN 37355-2438

Phone

(931) 450-1000

Fax

(931) 450-1004

NPI assigned

Mar 23, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Vanessa Streicher Green, DONPI 1023204278

Title

Owner/Medical Director

Phone

(931) 212-1479

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

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vanessa Streicher Green, DO

  • Family Medicine Physician
  • Manchester, TN
  • NPI 1023204278
  Medicare reassignment Care Compare group NPD Authorized official
• Shelly Marie Hargrove, NP-C

  • Family Nurse Practitioner
  • Brentwood, TN
  • NPI 1780961987
  Medicare reassignment Care Compare group NPD
• Victoria Campbell Chester, FNP-BC

  • Family Nurse Practitioner
  • Murfreesboro, TN
  • NPI 1689145435
  Medicare reassignment NPD

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1689323776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 MCBRIDES BRANCH RD",
            "city": "BEECHGROVE",
            "state": "TN",
            "postal_code": "370183718",
            "telephone_number": "931-212-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 WILLOW DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552438",
            "telephone_number": "931-450-1000",
            "fax_number": "931-450-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY MEDICINE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "STREICHER",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "931-212-1479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Health and Rehab LLC
• Legends Opco LLC
• Mike Lewis
• Carlton Brandon Long, BS, DC
• Josh Drew Lowry, PT
• Manchester Care Clinic LLC
• Manchester Center for Rehabilitation and Healing LLC
• Manchester Eyecare LLC
• Manchester Family Healthcare
• Manchester Family Practice

• Primary Care Clinic/Center in Manchester, TN
• Providers in Manchester, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.