NPIMap

Organization Active NPI

Community Care Clinic LLC

  • Family Medicine Physician
  • Cleveland, TN
National Provider Identifier
1699946103
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F0906005 Issued in TN
Legal business name
COMMUNITY CARE CLINIC LLC
Practice address
4867 Highway 411
Cleveland, TN 37323-5360
Phone
(423) 338-7434
Fax
(423) 338-7436
NPI assigned
Mar 13, 2008
Last updated
Mar 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Wendy L Beck, NP-C
Title
Practicioner/Owner
Phone
(423) 338-7434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X F0906005 TN Primary

Addresses

Primary practice location

4867 Highway 411
Cleveland, TN 37323-5360

Mailing address

PO Box 306
Ocoee, TN 37361-0306
Phone (423) 338-7434

National Provider Directory

National Provider Directory

Locations

227 Ocoee Xing NW
Cleveland, TN 37312
Phone (423) 472-4677

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1699946103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "OCOEE",
            "state": "TN",
            "postal_code": "373610306",
            "telephone_number": "423-338-7434",
            "fax_number": "423-338-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 HIGHWAY 411",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373235360",
            "telephone_number": "423-338-7434",
            "fax_number": "423-338-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICIONER/OWNER",
        "authorized_official_telephone_number": "423-338-7434",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "F0906005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.