Lark Medical Associates, LLC
Organization Active NPI Nurse Practitioner · Bulls Gap, TN
NPI 1831501501 · NPPES record last updated Apr 27, 2022
Key facts
- NPI
- 1831501501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APN0000006848 (TN)
- Legal business name
- LARK MEDICAL ASSOCIATES, LLC
- Practice address
- 275 Highway 11 E
Bulls Gap, TN 37711-3417 - Phone
- (423) 393-4052
- Fax
- (423) 933-2915
- NPI assigned
- May 28, 2014
- Organization subpart
- No
Authorized official
- Name
- Linda S Housewright, FNP
- Title
- Owner
- Phone
- (423) 393-4052
Practitioners 6
-
Angel Dawn Atkins, MSN, APRN, FNP-C
-
Linda S Housewright, FNP
-
Sherri Marcus, APRN
-
Mark R Doman, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2078987 | Lark Medical Associates, LLC | Certificate of waiver | Jun 8, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141208002387 | TN | Part B Supplier - Clinic/Group Practice | 8022330711 |
Receives reassigned benefits from 5 practitioners Practice locations: Bulls Gap, TN |
National Provider Directory
Locations
275 Highway 11 E
Bulls Gap, TN 37711
Phone (423) 235-2691
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | |||
| Nurse Practitioner |
363L00000X | APN0000006848 | TN | Yes |
Addresses
Primary practice location
275 Highway 11 E
Bulls Gap, TN 37711-3417
Mailing address
PO Box 8
Bulls Gap, TN 37711-0008
Phone (423) 393-4052
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q009488 | Medicaid | TN |
Other providers in Bulls Gap, TN
- Jose Garrido
- Kristie Vaughn Greenlee
- Megan Ann Hensley
- Linda S Housewright
- Timothy D Humann
- Main Street Family Practice
- Sherri Marcus
- Mark R. Doman, M.D. P.C.
- Brian T Miller
- Mobile Occ Med and Wellness, PLLC
All providers in Bulls Gap, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.