Manchester Care Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MANCHESTER CARE CLINIC LLC

Practice address

1019 Hillsboro Blvd
Manchester, TN 37355-2029

Phone

(931) 800-4622

NPI assigned

Jul 4, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Dawn Selvage, FNP-CNPI 1225592744

Title

Family Nurse Practitioner

Phone

(931) 570-0244

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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

• Dawn Selvage, FNP-C

  • Family Nurse Practitioner
  • Manchester, TN
  • NPI 1225592744
  Medicare reassignment Care Compare group NPD Authorized official
• Clint W Selvage, FNP

  • Family Nurse Practitioner
  • Winchester, TN
  • NPI 1275097503
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1770154429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373490480",
            "telephone_number": "931-800-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 HILLSBORO BLVD",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552029",
            "telephone_number": "931-800-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-04",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "SELVAGE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "931-570-0244",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legends Opco LLC
• Mike Lewis
• Carlton Brandon Long, BS, DC
• Josh Drew Lowry, PT
• Magnolia Family Medicine and Wellness
• Manchester Center for Rehabilitation and Healing LLC
• Manchester Eyecare LLC
• Manchester Family Healthcare
• Manchester Family Practice
• Manchester Residential, LLC

• Family Medicine Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.