Lunceford Primary Care, PLLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

LUNCEFORD PRIMARY CARE, PLLC

Practice address

4777 Andrew Jackson Pkwy Ste 101
Hermitage, TN 37076-1356

Phone

(615) 889-7010

Fax

(615) 889-0135

NPI assigned

Jan 28, 2025

Last updated

Jan 28, 2025By 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

Mary Kathryn Lunceford-Levesque, PA-CNPI 1598372047

Title

Owner

Phone

(615) 878-1533

Specialties & licenses 1

Addresses

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

Practitioners 2

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.

• Mary Kathryn Lunceford-Levesque, PA-C

  • Medical Physician Assistant
  • Brentwood, TN
  • NPI 1598372047
  Medicare reassignment Authorized official
• Cynthia L Wallace, M.D.

  • Family Medicine Physician
  • Hermitage, TN
  • NPI 1386615540
  NPD (past)

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1902619661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 ANDREW JACKSON PKWY STE 101",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761356",
            "telephone_number": "615-889-7010",
            "fax_number": "615-889-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 ANDREW JACKSON PKWY STE 101",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761356",
            "telephone_number": "615-889-7010",
            "fax_number": "615-889-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNCEFORD PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "LUNCEFORD-LEVESQUE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-878-1533",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lorenzo
• Lotus Psychiatric Center, LLC
• Jessica Conklin Louverture, MA
• Love Care Health Services LLC
• Casey Lowrance, D.O.
• Tori D Lurie, M.A.
• James Michael Lynch, MD
• Matthew Lyon
• Bethany Kaye Lyons
• Stephanie Mahon, PT, DPT

• Adult Medicine Physician in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Adult Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.