NPIMap

Organization Active NPI

McKenzie Medical Center PC

  • Rural Health Clinic/Center
  • Greenfield, TN
National Provider Identifier
1932084274
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MCKENZIE MEDICAL CENTER PC
Practice address
1731 S Meridian St
Greenfield, TN 38230
Phone
(731) 678-0055
Fax
(731) 678-0059
NPI assigned
Aug 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Tammy Etheridge
Title
Administrator
Phone
(731) 678-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1731 S Meridian St
Greenfield, TN 38230

Mailing address

1731 S Meridian St
Greenfield, TN 38230
Phone (731) 678-0055

Other names 1

  • Hometown Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250930004283 TN Part A Provider - Rural Health Clinic 2365427853 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenfield, TN

Rural health clinic certification: CCN 888945

Legal name
MCKENZIE MEDICAL CENTER PC
Doing business as
HOMETOWN HEALTH CLINIC GREENFIELD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 18, 2025
Last certification
Dec 18, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Enrollment address
1731 S Meridian St
Greenfield, TN 38230-1827

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

175 Wildcat Ln
Mc Kenzie, TN 38201
Phone (731) 352-4027

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bryan Hale Merrick Individual 5% Or Greater Direct Ownership InterestOwner Aug 4, 2025 50%
Corporate DirectorOwner Aug 4, 2025 50%
W-2 Managing EmployeeAd; Aug 4, 2025 50%
Terry Andrew Colotta Individual 5% Or Greater Direct Ownership InterestOwner Aug 4, 2025 50%
Corporate DirectorOwner Aug 4, 2025 50%
W-2 Managing EmployeeMD; Aug 4, 2025 50%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1932084274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 S MERIDIAN ST",
            "city": "GREENFIELD",
            "state": "TN",
            "postal_code": "38230",
            "telephone_number": "731-678-0055",
            "fax_number": "731-678-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 S MERIDIAN ST",
            "city": "GREENFIELD",
            "state": "TN",
            "postal_code": "38230",
            "telephone_number": "731-678-0055",
            "fax_number": "731-678-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-03",
        "status": "A",
        "authorized_official_last_name": "ETHERIDGE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "731-678-0055"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, TN

Sources for this page

Verify at the official NPI Registry.