Newbern Medical Clinic, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

APN5297 Issued in TN

Legal business name

NEWBERN MEDICAL CLINIC, PC

Practice address

105 N Monroe St
Newbern, TN 38059-1214

Phone

(731) 627-0734

Fax

(731) 627-0736

NPI assigned

Aug 20, 2007

Last updated

Aug 20, 2007By 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

Beverly McCann, FNPNPI 1275634214

Title

Owner/President

Phone

(731) 627-0734

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

Practitioners 3

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.

• Beverly D McCann, FNP

  • Nurse Practitioner
  • Newbern, TN
  • NPI 1275634214
  Medicare reassignment NPD Authorized official
• Kelly Alexandria Harden, DNSC, FNP-BC

  • Family Nurse Practitioner
  • Newbern, TN
  • NPI 1194723056
  Medicare reassignment NPD
• Phyllis P Moore, DNP,FNP-BC

  • Family Nurse Practitioner
  • Friendship, TN
  • NPI 1023374279
  NPD

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1790978294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N MONROE ST",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "380591214",
            "telephone_number": "731-627-0734",
            "fax_number": "731-627-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N MONROE ST",
            "city": "NEWBERN",
            "state": "TN",
            "postal_code": "380591214",
            "telephone_number": "731-627-0734",
            "fax_number": "731-627-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERN MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "731-627-0734",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "APN5297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3727670",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Ellen Moody, LCSW
• Clint Edward Myers, PHARM D
• Christy R Newbaker
• David Allen Newbaker, DPH
• Newbern Discount Drug LLC
• Presley Diabetes and Endocrine Center, PLLC
• Kagan Marie Qualls, COTA/L
• Logan J Rummells
• Wanda Faye Smith, RN
• West Family Care Clinic PLLC (West Family Care Clinic)

• Primary Care Clinic/Center in Newbern, TN
• Providers in Newbern, 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 Aug 20, 2007; 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.