Active NPI
Michie Medical Clinic, Inc.
- Rural Health Clinic/Center
- Michie, TN
National Provider Identifier
1861695900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- MICHIE MEDICAL CLINIC, INC.
- Practice address
- 6659 Michie Pebble Hill Rd
Michie, TN 38357-5115 - Phone
- (731) 632-1783
- NPI assigned
- Jun 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brandon K Sumler
- Title
- Director
- Phone
- (731) 632-1783
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | APN0000006617 | TN | |
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
6659 Michie Pebble Hill Rd
Michie, TN 38357-5115
Mailing address
6659 Michie Pebble Hill Rd
Michie, TN 38357-5115
Phone (731) 632-1783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
Rural health clinic certification: CCN 448932
- Legal name
- MICHIE MEDICAL CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 28, 2014
- Last certification
- Dec 12, 2022
- Ownership / control type
- 1B
- Organization structure
- Corporation
- Incorporated
- Oct 11, 2001 in TN
- Enrollment address
- 6659 Michie Pebble Hill Rd
Michie, TN 38357-5115
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0957508 | Michie Medical Clinic Inc | Certificate of waiver | Feb 20, 2028 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400014
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Campbell and Ford Construction | 5% Or Greater Direct Ownership Interest | Aug 21, 2025 | 100% |
| Michael Campbell | 5% Or Greater Indirect Ownership Interest | Aug 21, 2025 | 50% |
| Corporate Officer | Aug 21, 2025 | 50% | |
| Operational/Managerial Control | Aug 21, 2025 | 50% | |
| Andre Ford | 5% Or Greater Indirect Ownership Interest | Aug 21, 2025 | 50% |
| Corporate Officer | Aug 21, 2025 | 50% | |
| Operational/Managerial Control | Aug 21, 2025 | 50% | |
| Brandon Sumler | Corporate Officer | Aug 21, 2025 | |
| W-2 Managing Employee | Aug 21, 2025 |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Michie, TN
- NPI 1386699361
-
- Family Nurse Practitioner
- Michie, TN
- NPI 1902301237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758585600000",
"number": "1861695900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6659 MICHIE PEBBLE HILL RD",
"city": "MICHIE",
"state": "TN",
"postal_code": "383575115",
"telephone_number": "731-632-1783",
"fax_number": "731-632-1786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6659 MICHIE PEBBLE HILL RD",
"city": "MICHIE",
"state": "TN",
"postal_code": "383575115",
"telephone_number": "731-632-1783"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHIE MEDICAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-06",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A",
"authorized_official_last_name": "SUMLER",
"authorized_official_first_name": "BRANDON",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "731-632-1783"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "TN",
"license": "APN0000006617",
"primary": false
},
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Michie, TN
- Hillside New Beginnings
- Alaina M Hutchings, RBT
- Magnolia Regional Health Center (Magnolia Primary Care - Michie Tennessee)
- Michie Health LLC
- Michie Healthcare Associates, LLC
- Michie Pharmacy
- Michie Pharmacy Inc (Michie Pharmacy)
- Linda Faye Moore
- Regional Health Care Solutions Inc (Regional Phcy)
- Mary Sue Rhoads, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.