Emerald Primary Care and Wellness Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EMERALD PRIMARY CARE AND WELLNESS CLINIC

Doing business as

Emerald Primary Care and Wellness Clinic, PLLC

Practice address

815 Needham Dr
Smyrna, TN 37167-9403

Phone

(601) 672-9730

NPI assigned

Jan 29, 2021

Last updated

Mar 29, 2021By 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

Centeria Green Woolfolk, FNP-C

Title

Owner/ Family Nurse Practitioner

Phone

(601) 672-9730

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Emerald Primary Care and Wellness Clinic, PLLC Doing business as

Locations

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1932790128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 BRITANNIA WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293791",
            "telephone_number": "601-672-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 NEEDHAM DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371679403",
            "telephone_number": "601-672-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD PRIMARY CARE AND WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "WOOLFOLK",
        "authorized_official_first_name": "CENTERIA",
        "authorized_official_middle_name": "GREEN",
        "authorized_official_title_or_position": "OWNER/ FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-672-9730",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104343318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Primary Care and Wellness Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emerald Primary Care and Wellness Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin O'Leary Elliott, FNP-C
• Susan E Elliott, FNP-C
• Alicia Michelle Ellis, ED.D., LPC-MHSP
• Stephanie Elizabeth Ellis
• Emerald Group LLC (The Waterford Of Smyrna)
• Lily Emerson
• Eminence Care LLC
• Empact Ambulance Service Inc
• Empact Medical Services
• Empower HCS, LLC

• Family Medicine Physician in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.