Active NPI
Walk in Clinic of Sparta LLC.
- Medical Physician Assistant
- Sparta, TN
National Provider Identifier
1952438020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0000000834
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3725921 | Other | TN | MEDICARE GROUP PTAN NUMBER |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Other Technician
- Sparta, TN
- NPI 1497144463
-
- Other Technician
- Sparta, TN
- NPI 1174912158
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.