Dunlap Medical Center, PLLC
Organization Active NPI Family Medicine Physician · Dunlap, TN
NPI 1962591982 · NPPES record last updated Aug 2, 2011
Key facts
- NPI
- 1962591982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- DUNLAP MEDICAL CENTER, PLLC
- Practice address
- 67 Cates Street
Dunlap, TN 37327-1777 - Phone
- (423) 949-2171
- Fax
- (423) 949-5118
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan M. Olinger, CPC
- Title
- Office Manager
- Phone
- (423) 949-2171
Practitioners 7
-
George N. Graves, D.O.
-
Danny Ray Nelson, NP-C
-
Laura Ashley Hennessey, MSN, NP-C
-
Holly Dawn Walker, FNP-BC
-
Penny Jeannay Milligan, NP-C
-
Donna Kay Wright, APN-BC
-
Esther Cammack Fernandez, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0309484 | Dunlap Medical Center PLLC | Certificate of waiver | Aug 4, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050323001066 | TN | Part B Supplier - Clinic/Group Practice | 0749236610 |
Receives reassigned benefits from 4 practitioners Practice locations: Dunlap, TN |
National Provider Directory
Locations
67 Cates St
Dunlap, TN 37327
Phone (423) 949-2171
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
67 Cates Street
Dunlap, TN 37327-1777
Mailing address
PO Box 1777
Dunlap, TN 37327-1777
Phone (423) 949-2171
Other providers in Dunlap, TN
- Ramsey Daugherty
- Tarrah Davis
- Kathryn E Deberry
- Tera Chea Denton
- Dr. Debora Daniel
- Dunns Family Health Care LLC
- Ashley Shay Eaton
- Cara English
- Sherry Fanous
- Fast Pace Medical Clinic PLLC
All providers in Dunlap, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.