NPIMap

Organization Active NPI

Primary Healthcare of Millington

  • Primary Care Clinic/Center
  • Millington, TN
National Provider Identifier
1871587519
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
18070 Issued in TN
Legal business name
PRIMARY HEALTHCARE OF MILLINGTON
Practice address
4772 Navy Rd
Millington, TN 38053-1927
Phone
(901) 873-4501
Fax
(901) 873-4501
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Regina S Lindsey, MD
Title
Physician Owner
Phone
(901) 873-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 18070 TN Primary

Addresses

Primary practice location

4772 Navy Rd
Millington, TN 38053-1927

Mailing address

4772 Navy Rd
Millington, TN 38053-1927
Phone (901) 873-4501

Other identifiers 3

IdentifierTypeStateIssuer
3374920MedicaidTN
4040083OtherTNBCBS
4040083MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Family Healthcare of Millington Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1871587519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 NAVY RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531927",
            "telephone_number": "901-873-4501",
            "fax_number": "901-873-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 NAVY RD",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531927",
            "telephone_number": "901-873-4501",
            "fax_number": "901-873-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTHCARE OF MILLINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "901-873-4501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "18070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3374920",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4040083",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4040083",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.