Organization Active NPI

Walk in Clinic of Sparta LLC.

  • Medical Physician Assistant
  • Sparta, TN
National Provider Identifier
1952438020
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0000000834 Issued in TN
Legal business name
WALK IN CLINIC OF SPARTA LLC.
Practice address
396 N Spring St
Sparta, TN 38583-1327
Phone
(931) 836-2228
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Mr. Wayne Durbin, PHYSICIAN ASSISTANT
Title
President
Phone
(931) 836-2228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA0000000834 TN Primary

Addresses

Primary practice location

396 N Spring St
Sparta, TN 38583-1327

Mailing address

396 N Spring St
Sparta, TN 38583-1327
Phone (931) 836-2228

Other identifiers 1

IdentifierTypeStateIssuer
3725921OtherTNMEDICARE GROUP PTAN NUMBER

National Provider Directory

National Provider Directory

Locations

396 N Spring St
Sparta, TN 38583
Phone (931) 836-2228

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1952438020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 N SPRING ST",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831327",
            "telephone_number": "931-836-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 N SPRING ST",
            "city": "SPARTA",
            "state": "TN",
            "postal_code": "385831327",
            "telephone_number": "931-836-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALK IN CLINIC OF SPARTA LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-836-2228",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0000000834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN NUMBER",
            "identifier": "3725921",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.