NPIMap

Organization Active NPI

Womans Clinic a Professional Association

  • Obstetrics & Gynecology Physician
  • Jackson, TN
National Provider Identifier
1962456574
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMANS CLINIC A PROFESSIONAL ASSOCIATION
Practice address
244 Coatsland Dr
Jackson, TN 38301-3948
Phone
(731) 422-4642
Fax
(731) 422-2277
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Authorized official

Name
Mrs. Catherine J Dillon
Title
Business Office MGR
Phone
(731) 422-4642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

244 Coatsland Dr
Jackson, TN 38301-3948

Mailing address

244 Coatsland Dr
Jackson, TN 38301-3948
Phone (731) 422-4642

Other identifiers 1

IdentifierTypeStateIssuer
3383748MedicaidTN

Other names 1

  • Womans Clinic PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041217000323 TN Part B Supplier - Clinic/Group Practice 1355308677 Receives reassigned benefits from 19 practitioners
Practice locations: Jackson, TN

National Provider Directory

National Provider Directory
Tax ID family
Woman'S Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

72 Physicians Dr
Jackson, TN 38305
Phone (731) 660-6395

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1962456574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 COATSLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013948",
            "telephone_number": "731-422-4642",
            "fax_number": "731-422-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 COATSLAND DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013948",
            "telephone_number": "731-422-4642",
            "fax_number": "731-422-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMANS CLINIC A PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OFFICE MGR",
        "authorized_official_telephone_number": "731-422-4642",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3383748",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Womans Clinic PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.