Community Clinic Shelbyville and Bedford Co.Inc.,

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COMMUNITY CLINIC SHELBYVILLE AND BEDFORD CO.INC.,

Doing business as

Community Clinic Shelbyville and Bedford Co.
Community Clinic Shelbyville and Bedford Co., Inc.

Practice address

200 Dover St Ste 202
Shelbyville, TN 37160-2799

Phone

(931) 684-6772

Fax

(931) 684-6721

NPI assigned

Feb 28, 2023

Last updated

Feb 28, 2023By 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

Lisa Carden

Title

Director of Dental Operations

Phone

(931) 684-6772

Specialties & licenses 1

Addresses

Other names 2

• Community Clinic Shelbyville and Bedford Co. Doing business as
• Community Clinic Shelbyville and Bedford Co., Inc. Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16097/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1760181762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOVER ST STE 202",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602799",
            "telephone_number": "931-684-6772",
            "fax_number": "931-684-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOVER ST STE 202",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602799",
            "telephone_number": "931-684-6772",
            "fax_number": "931-684-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC SHELBYVILLE AND BEDFORD CO.INC.,",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "CARDEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF DENTAL OPERATIONS",
        "authorized_official_telephone_number": "931-684-6772"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Clinic Shelbyville and Bedford Co.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Clinic Shelbyville and Bedford Co., Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirston Clinton, OTR/L
• Tiffany Coggins, FNP-C
• Dustin Tait Coker, B.S.
• Robert James Colasso, PT
• George H. Collins, M.D.
• Stephanie Ann Cook, B.S.
• Judy P Cooper, RN
• Cindy Leanne Cothran, MS
• County of Bedford Office of County Executive (Bedford County Emergency Medical Service)
• Phillip J Cover, MD

• General Practice Dentistry in Shelbyville, TN
• Providers in Shelbyville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.